Intravenous arketamine for treatment-resistant depression: open-label pilot study

• Published in: European archives of psychiatry and clinical neuroscience Vol. 271; no. 3; pp. 577 - 582
• Main Authors: Leal, Gustavo C., Bandeira, Igor D., Correia-Melo, Fernanda S., Telles, Manuela, Mello, Rodrigo P., Vieira, Flavia, Lima, Cassio S., Jesus-Nunes, Ana Paula, Guerreiro-Costa, Lívia N. F., Marback, Roberta F., Caliman-Fontes, Ana Teresa, Marques, Breno L. S., Bezerra, Marília L. O., Dias-Neto, Alberto L., Silva, Samantha S., Sampaio, Aline S., Sanacora, Gerard, Turecki, Gustavo, Loo, Colleen, Lacerda, Acioly L. T., Quarantini, Lucas C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2021; Springer Nature B.V
• Subjects: Enantiomers; Intravenous administration; Ketamine; Medicine; Medicine & Public Health; Mental depression; Neurosciences; Psychiatry; Short Communication; Treatment resistance; Rapid-acting antidepressant; (; Ketamine; Arketamine; Major depressive disorder; Treatment-resistant depression; (R)-Ketamine
• ISSN: 0940-1334; 1433-8491; 1433-8491
• DOI: 10.1007/s00406-020-01110-5

We aimed to analyze the efficacy and safety of arketamine, the R (−)-enantiomer of ketamine, for treatment-resistant depression (TRD) in humans. Open-label pilot trial, seven subjects with TRD received a single intravenous infusion of arketamine (0.5 mg/kg); primary outcome was change in Montgomery–Åsberg Depression Rating Scale (MADRS) 24 h after. Mean MADRS dropped from 30.7 before infusion to 10.4 after one day, a mean difference of 20.3 points [CI 95% 13.6–27.0; p  < 0.001]; dissociation was nearly absent. Arketamine might produce fast-onset and sustained antidepressant effects in humans with favorable safety profile, like previously reported with animals; further controlled-trials are needed.