Skip to main content
×
×
Home

Characteristics of patients expressing an interest in ketamine treatment: results of an online survey

  • Jolien K. E. Veraart (a1), Sanne Y. Smith-Apeldoorn (a2), Hayley Trueman (a3), Marrit K. de Boer (a4), Robert A. Schoevers (a5) and Rupert McShane (a6)...
Abstract
Background

Off-label ketamine treatment has shown acute antidepressant effects that offer hope for patients with therapy-resistant depression. However, its potential for integration into treatment algorithms is controversial, not least because the evidence base for maintenance treatment with repeated ketamine administration is currently weak. Ketamine is also a drug of misuse, which has raised concerns regarding the target population. Little is known about which patients would seek ketamine treatment if it were more widely available.

Aims

To explore some of the characteristics of the patients actively seeking ketamine treatment.

Method

An online survey containing questions about duration of current depressive episode, number of antidepressants used and other comments was completed by patients who were exploring the internet regarding the possibility of ketamine for depression.

Results

Of the 1088 people who registered their interest, 93.3% reported depression, 64.3% reported a chronic course of their symptoms and in the past 10 years, 86.3% had tried at least two antidepressants. Desperation was a common theme, but this appeared to be competently expressed. A small minority (<8%) reported experience of illegal ketamine use.

Conclusions

It cannot be ruled out that patients with different degrees of treatment resistance and comorbidities will seek treatment with ketamine. This stresses the urgency to perform larger randomised controlled trials as well as to systematically monitor outcomes and adverse effects of ketamine, that is currently prescribed off-label for patients in need.

Declaration of interest

R.M. is consulting and is Principal Investigator for Janssen trials of esketamine and is consulting for Eleusis.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Characteristics of patients expressing an interest in ketamine treatment: results of an online survey
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Characteristics of patients expressing an interest in ketamine treatment: results of an online survey
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Characteristics of patients expressing an interest in ketamine treatment: results of an online survey
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Correspondence: Jolien K. E. Veraart, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands. Email: j.k.e.veraart@umcg.nl
References
Hide All
1Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386: 743800.
2Gaynes, BN, Warden, D, Trivedi, MH, Wisniewski, SR, Fava, M, Rush, AJ. What did STAR*D teach us? Results from a large-scale, practical, clinical trial for patients with depression. Psychiatr Serv 2009; 60: 1439–45.
3Rush, AJ, Trivedi, MH, Wisniewski, SR, Nierenberg, AA, Stewart, JW, Warden, D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry 2006; 163: 1905–17.
4Caddy, C, Amit, BH, McCloud, TL, Rendell, JM, Furukawa, TA, McShane, R, et al. Ketamine and other glutamate receptor modulators for depression in adults. Cochrane Database Syst Rev 2015; 9: CD011612.
5Han, Y, Chen, J, Zou, D, Zheng, P, Li, Q, Wang, H, et al. Efficacy of ketamine in the rapid treatment of major depressive disorder: a meta-analysis of randomized, double-blind, placebo-controlled studies. Neuropsychiatr Dis Treat 2016; 12: 2859–67.
6Kishimoto, T, Chawla, JM, Hagi, K, Zarate, CA, Kane, JM, Bauwer, M, et al. Single-dose infusion ketamine and non-ketamine N-methyl-d-aspartate receptor antagonists for unipolar and bipolar depression: a meta-analysis of efficacy, safety and time trajectories. Psychol Med 2016; 46: 1459–72.
7Zhang, MWB, Hong, YX, Husain, SF, Harris, KM, Ho, RC. Analysis of print news media framing of ketamine treatment in the United States and Canada from 2000 to 2015. PLoS One 2017; 12: e0173202.
8Sanacora, G, Frye, MA, McDonald, W, Mathew, SJ, Turner, MS, Schatzberg, AF, et al. A consensus statement on the use of ketamine in the treatment of mood disorders. JAMA 2017; 74: 399405.
9Ketamine Advocacy Network. Mission and Vision. Ketamine Advocacy Network, 2015 (www.ketamineadvocacynetwork.org/mission-and-vision).
10Loo, C. Can we confidently use ketamine as a clinical treatment for depression? Lancet Psychiatry 2018; 5: 1112.
11Schatzberg, AF. A word to the wise about ketamine. Am J Psychiatry 2014; 171: 262–4.
12Singh, I, Morgan, C, Curran, V, Nutt, D, Schlag, A, McShane, R. Ketamine treatment for depression: opportunities for clinical innovation and ethical foresight. Lancet Psychiatry 2017; 4: 419–26.
13Diamond, PR, Farmery, AD, Atkinson, S, Haldar, J, Williams, N, Cowen, PJ, et al. Ketamine infusions for treatment resistant depression: a series of 28 patients treated weekly or twice weekly in an ECT clinic. J Psychopharmacol 2014; 28: 536–44.
14Oxford Health NHS Foundation Trust. First UK study of ketamine for people with severe depression. Oxford Health NHS Foundation Trust, 2014 (www.oxfordhealth.nhs.uk/news/first-uk-study-of-ketamine-for-people-with-severe-depression).
15Berlim, MT, Turecki, G. Definition, assessment, and staging of treatment-resistant refractory major depression: a review of current concepts and methods. Can J Psychiatry 2007; 52: 4654.
16Ionescu, DF, Swee, MB, Pavone, KJ, Taylor, N, Akeju, O, Baer, L, et al. Rapid and sustained reductions in current suicidal ideation following repeated doses of intravenous ketamine: secondary analysis of an open-label study. J Clin Psychiatry 2016; 77: e719–25.
17Apeldoorn, SY, de Boer, MK, Schoevers, RA. Reduction in suicidal ideation following repeated doses of intravenous ketamine? J Clin Psychiatry 2017; 78: e71.
18Sanacora, G, Heimer, H, Hartman, D, Mathew, SJ, Frye, M, Nemeroff, C, et al. Balancing the promise and risks of ketamine treatment for mood disorders. Neuropsychopharmacology 2016; 42: 1179–81.
19Rush, AJ, Gullion, CM, Basco, MR, Jarrett, RB, Trivedi, MH. The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychol Med 1996; 26: 477–86.
20Jakovljevic, M. Creative, person-centered and narrative psychopharmacotherapy or how to prevent and overcome treatment resistance in psychiatry. Psychiatr Danub 2015; 27: 291301.
21Rasmussen, KG, Mueller, M, Kellner, CH, Knapp, RG, Petrides, G, et al. Patterns of psychotropic medication use among patients with severe depression referred for electroconvulsive therapy: data from the Consortium for Research on Electroconvulsive Therapy. J ECT 2006; 22: 116–23.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Open
  • ISSN: -
  • EISSN: 2056-4724
  • URL: /core/journals/bjpsych-open
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Characteristics of patients expressing an interest in ketamine treatment: results of an online survey

  • Jolien K. E. Veraart (a1), Sanne Y. Smith-Apeldoorn (a2), Hayley Trueman (a3), Marrit K. de Boer (a4), Robert A. Schoevers (a5) and Rupert McShane (a6)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *