IV ketamine is effective for geriatric patients with treatment-resistant depression; the response rate was similar to that observed in younger adult patients, two new studies suggest.
. In addition, the drug's high cost and poor bioavailability in comparison with IV ketamine remains an issue, said Oughli.study, a placebo-controlled randomized trial, there was no difference between esketamine, used in conjunction with an antidepressant, and placebo for geriatric patients.
Results showed that with regard to depression severity, as assessed using Beck Depression Inventory scores, 27.8% of patients in the geriatric group had a 50% or greater improvement, vs 25.4% of those younger than 60. The secondary analysis of the trial focused on 23 patients who had been initially treated with twice-a-week IV ketamine for 4 weeks.
These findings are consistent with research in younger adults and demonstrate that twice-weekly infusions yield a more sustained antidepressant response than once-weekly infusions, the authors note. Oughli said that in both analyses, patients tolerated ketamine well, and there were no serious adverse events.
"Particularly with some of my older patients, the kind of psychotomimetic properties of ketamine and the out-of-body experiences [with the initial treatment] can be frightening," he said."They may be willing to try, but I've had more than one patient quit after one treatment because they became so frightened."
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