Original Research

Ketamine for depressive symptoms: A retrospective chart review of a private ketamine clinic

Vidette M. Juby, Saaeda Paruk, Mitsuaki Tomita, Bonga Chiliza
South African Journal of Psychiatry | Vol 30 | a2176 | DOI: https://doi.org/10.4102/sajpsychiatry.v30i0.2176 | © 2024 Vidette M. Juby, Saaeda Paruk, Mitsuaki Tomita, Bonga Chiliza | This work is licensed under CC Attribution 4.0
Submitted: 30 August 2023 | Published: 19 February 2024

About the author(s)

Vidette M. Juby, Discipline of Psychiatry, College of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Saaeda Paruk, Discipline of Psychiatry, College of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Mitsuaki Tomita, Discipline of Psychiatry, College of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
Bonga Chiliza, Discipline of Psychiatry, College of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa

Abstract

Background: There is currently no published evidence demonstrating the effectiveness and safety of subanaesthetic doses of ketamine, when administered intravenously as an adjunct treatment for depressive symptoms, in a real world setting in South Africa.

Aim: This retrospective chart review reports the clinical response (change in Patient Health Questionnaire – 7 score) to an initial infusion series of ketamine added to usual treatment, and the pattern of its subsequent maintenance use, for depressive symptoms.

Setting: A private ketamine clinic in Hilton, KwaZulu-Natal.

Methods: The medical records of all patients who attended a private ketamine clinic between August 2019 and 31 May 2021 were retrospectively analysed. Depression symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9) administered immediately before and 24 h after each treatment. Response was defined as a score decrease of more than 50%.

Results: Among the 154 patients who received ketamine infusions for depression, 67 completed a six infusion initial series, with a response rate of 60.6% and remission rate of 32.4%. Of the 154, 50% no longer experienced any suicidal ideation after treatment and adverse events were uncommon, with 6.2% of infusions requiring intervention for adverse events, mostly nausea. In addition, 48.5% of those who completed the initial series continued to receive maintenance infusions, with no evidence of escalating use or abuse.

Conclusion: Incorporating intravenous ketamine into the existing treatment regimens at a private clinic was associated with reduced acuteness of depression severity and suicidal ideation. This approach appeared safe and tolerable, showing no signs of abuse or dependence.

Contribution: This is the first known naturalistic study reporting on ketamine use for depressive symptoms in South Africa.


Keywords

ketamine; intravenous; induction; maintenance; major depression

Sustainable Development Goal

Goal 3: Good health and well-being

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