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Sarah Brand

Sarah Brand

Safety and efficacy of maintenance ketamine treatment in patients with treatment-refractory generalized anxiety and social anxiety disorders.

Glue, P., Neehoff, S. M., Medlicott, N. J., Gray, A., Kibby, G., & McNaughton, N. (2018). Safety and efficacy of maintenance ketamine treatment in patients with treatment-refractory generalized anxiety and social anxiety disorders. Journal of Psychopharmacology, 32(6), 663–667.

 

Highlights:

  • In this maintenance treatment study, we sought to evaluate the effect on anxiety ratings, safety and tolerability of 3 months of weekly ketamine in 20 patients with treatment-refractory DSM IV generalized anxiety disorder (GAD) and/or social anxiety disorder (SAD), and subsequent assessment of remission post-treatment.
  • This was an uncontrolled open-label study in 20 patients who had been responders in an ascending dose ketamine study…Patients received one or two weekly ketamine doses of 1 mg/kg injected subcutaneously for 3 months.
  • Patients reported marked improvements in functionality and in their personal lives. Maintenance ketamine may be a therapeutic alternative for patients with treatment-refractory GAD/SAD.

Results:

There were 10 women (50%) and 10 men (50%); 15 patients (75%) met the criteria for GAD and 18 (90%) for SAD. One hour after dosing, Fear Questionnaire ratings decreased by ~50%, as did Hamilton Anxiety ratings. Clinician-Administered Dissociative States Scale mean scores declined over time, from 20 points at week 1 to 8.8 points at week 14. Compared with pre-dose values, mean systolic and diastolic blood pressure increased by ~10 mm Hg at 30 min. The most common adverse events were nausea, dizziness, and blurred vision. Of the 20 patients, 18 reported improved social functioning and/or work functioning during maintenance treatment.

Conclusions:

Weekly ketamine dosing was safe and well tolerated, and post-dose dissociative symptoms tended to reduce after repeated dosing. Patients reported marked improvements in functionality and in their personal lives. Maintenance ketamine may be a therapeutic alternative for patients with treatment-refractory GAD/SAD.

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