Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world study
Background: Ketamine shows promise for treating bipolar depression, particularly in severe cases. However, the optimal administration route and enantiomer (esketamine, arketamine, or racemic mixture) remain unclear. This case series presents data on intravenous (IV) esketamine in bipolar depression,...
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Elsevier
2025-01-01
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| Series: | Journal of Affective Disorders Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666915324001562 |
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| author | Naima Guhad Shire Michael Ioannou Örjan Falk Ane Bakken Wold Caroline Wass Zoltán Szabó Steinn Steingrimsson |
| author_facet | Naima Guhad Shire Michael Ioannou Örjan Falk Ane Bakken Wold Caroline Wass Zoltán Szabó Steinn Steingrimsson |
| author_sort | Naima Guhad Shire |
| collection | DOAJ |
| description | Background: Ketamine shows promise for treating bipolar depression, particularly in severe cases. However, the optimal administration route and enantiomer (esketamine, arketamine, or racemic mixture) remain unclear. This case series presents data on intravenous (IV) esketamine in bipolar depression, addressing a gap in published literature. Methods: This retrospective chart review included adult inpatients with bipolar depression treated with multiple IV esketamine infusions. Outcomes were measured using the self-rated Montgomery Åsberg Depression Scale (MADRS-S) and clinician-rated improved Global Clinical Impression Scale-Severity Index (rCGI-S). Tolerability data were also collected. Results: Thirteen patients received 4–6 IV esketamine infusions over two weeks. Statistically significant improvements were observed in MADRS-S total scores (p = 0.002) and rCGI-S scores (p < 0.001) but not in MADRS-S suicidal thoughts item (p = 0.125). Infusions were generally well-tolerated, with treatment-emergent hypomania in two patients (15.4 %). Limitations: The retrospective design without a control group limited effectiveness evaluation. Conclusions: Preliminary results of IV esketamine for bipolar depression are promising, but its role in treatment algorithms requires clarification. Randomized controlled studies are needed to investigate its effectiveness further. |
| format | Article |
| id | doaj-art-3e49502eb92544aca90c1103c7bdfd32 |
| institution | Kabale University |
| issn | 2666-9153 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Affective Disorders Reports |
| spelling | doaj-art-3e49502eb92544aca90c1103c7bdfd322025-01-08T04:53:47ZengElsevierJournal of Affective Disorders Reports2666-91532025-01-0119100870Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world studyNaima Guhad Shire0Michael Ioannou1Örjan Falk2Ane Bakken Wold3Caroline Wass4Zoltán Szabó5Steinn Steingrimsson6Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, SwedenRegion Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden; University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden; Correspondence at Department of Research and Development (FoU-enhet), Psykiatri Affektiva/ Sahlgrenska University Hospital, Journalvägen 41650, Gothenburg, Sweden.Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden; University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, SwedenRegion Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, SwedenRegion Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden; University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, SwedenRegion Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, SwedenRegion Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden; University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, SwedenBackground: Ketamine shows promise for treating bipolar depression, particularly in severe cases. However, the optimal administration route and enantiomer (esketamine, arketamine, or racemic mixture) remain unclear. This case series presents data on intravenous (IV) esketamine in bipolar depression, addressing a gap in published literature. Methods: This retrospective chart review included adult inpatients with bipolar depression treated with multiple IV esketamine infusions. Outcomes were measured using the self-rated Montgomery Åsberg Depression Scale (MADRS-S) and clinician-rated improved Global Clinical Impression Scale-Severity Index (rCGI-S). Tolerability data were also collected. Results: Thirteen patients received 4–6 IV esketamine infusions over two weeks. Statistically significant improvements were observed in MADRS-S total scores (p = 0.002) and rCGI-S scores (p < 0.001) but not in MADRS-S suicidal thoughts item (p = 0.125). Infusions were generally well-tolerated, with treatment-emergent hypomania in two patients (15.4 %). Limitations: The retrospective design without a control group limited effectiveness evaluation. Conclusions: Preliminary results of IV esketamine for bipolar depression are promising, but its role in treatment algorithms requires clarification. Randomized controlled studies are needed to investigate its effectiveness further.http://www.sciencedirect.com/science/article/pii/S2666915324001562EsketamineBipolar depressionIntravenous infusionTreatment-resistantInpatient careAntidepressant efficacy |
| spellingShingle | Naima Guhad Shire Michael Ioannou Örjan Falk Ane Bakken Wold Caroline Wass Zoltán Szabó Steinn Steingrimsson Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world study Journal of Affective Disorders Reports Esketamine Bipolar depression Intravenous infusion Treatment-resistant Inpatient care Antidepressant efficacy |
| title | Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world study |
| title_full | Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world study |
| title_fullStr | Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world study |
| title_full_unstemmed | Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world study |
| title_short | Repeated intravenous infusions of esketamine in inpatients with bipolar depression: A retrospective real-world study |
| title_sort | repeated intravenous infusions of esketamine in inpatients with bipolar depression a retrospective real world study |
| topic | Esketamine Bipolar depression Intravenous infusion Treatment-resistant Inpatient care Antidepressant efficacy |
| url | http://www.sciencedirect.com/science/article/pii/S2666915324001562 |
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