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Interest-activity symptom severity predicts response to ketamine infusion in treatment-resistant depression

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Abstract

Background

Interest and activity are part of the positive mood domain. Evidence suggests the symptom domain of interest-activity at baseline as a clinical predictor for treatment response to traditional antidepressants. However, whether this domain is related to the response to a single low-dose ketamine infusion remains unclear.

Methods

Seventy-one patients with treatment-resistant depression were randomized to 3 treatment groups: a single 0.5 or 0.2 mg/kg ketamine or normal saline placebo infusion. Depressive symptoms were measured using the 17-item Hamilton Depression Rating Scale before infusions and at postinfusion period (at 40 min and up to 2 weeks). Low (mild) versus medium versus high (severe) interest-activity symptom domain groups were classified on the basis of the cutoff point of ± 0.4 standard deviation. The effect of baseline interest-activity symptoms on outcomes was tested using generalized estimating equation models.

Results

The interest-activity symptom domain as a continuous variable (β = 8.413, p = .016) was related to the trajectory of depressive symptoms. Stratified by levels of the interest-activity symptom domain, in the low interest-activity, 0.2 mg/kg ketamine infusion (β = 0.013) demonstrated the greatest antidepressant effect (p < .01) compared with 0.5 mg/kg ketamine (β = 0.739) and placebo infusions; however, in the high interest-activity, 0.5 mg/kg ketamine infusion (β = 0.001) demonstrated the best antidepressant effect (p < .01) compared with 0.2 mg/kg ketamine (β = 1.372) and placebo infusions.

Discussion

The symptom domain of interest-activity was an independent predictor for the treatment response to a single low-dose ketamine infusion.

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Acknowledgments

We thank all research assistants, physicians, pharmacist, and nursing staffs at D020 Unit of Taipei Veterans General Hospital for their assistance during the study process, without whom this work could have been possible. We thank Mr. I-Fan Hu for his support and friendship.

Funding

The study was supported by grant from Taipei Veterans General Hospital (V106B-020, V107B-010, V107C-181, V108B-012), Yen Tjing Ling Medical Foundation (CI-110-30) and Ministry of Science and Technology, Taiwan (107-2314-B-075-063-MY3, 108-2314-B-075 -037). The funding source had no role in any process of our study.

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Authors and Affiliations

  1. Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec.2, Shih-Pai Road, Beitou District, Taipei, 112, Taiwan

    Mu-Hong Chen, Wei-Chen Lin, Ya-Mei Bai, Cheng-Ta Li, Shih-Jen Tsai, Chen-Jee Hong, Pei-Chi Tu & Tung-Ping Su

  2. Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan

    Mu-Hong Chen, Wei-Chen Lin, Hui-Ju Wu, Ya-Mei Bai, Cheng-Ta Li, Shih-Jen Tsai, Chen-Jee Hong, Pei-Chi Tu & Tung-Ping Su

  3. Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan

    Mu-Hong Chen, Wei-Chen Lin, Cheng-Ta Li, Shih-Jen Tsai, Chen-Jee Hong & Tung-Ping Su

  4. Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan

    Pei-Chi Tu & Tung-Ping Su

  5. Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan

    Tung-Ping Su

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  1. Mu-Hong Chen
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Correspondence to Wei-Chen Lin or Tung-Ping Su.

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Chen, MH., Lin, WC., Wu, HJ. et al. Interest-activity symptom severity predicts response to ketamine infusion in treatment-resistant depression. Psychopharmacology 238, 857–865 (2021). https://doi.org/10.1007/s00213-020-05737-z

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  • DOI: https://doi.org/10.1007/s00213-020-05737-z

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