Format

Send to

Choose Destination
J Psychopharmacol. 2015 May;29(5):591-5. doi: 10.1177/0269881114544776. Epub 2014 Aug 13.

Hippocampal volume and the rapid antidepressant effect of ketamine.

Author information

1
Clinical Neuroscience Division, National Center for Post-traumatic Stress Disorder (PTSD), West Haven, CT, USA Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA chadi.abdallah@yale.edu.
2
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
3
Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.
4
Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil Center of Mathematics, Computation and Cognition; Universidade Federal do ABC, Santo Andre, Brazil.
5
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA Mental Health Care Line, Michael E Debakey Veterans' Administration (VA) Medical Center, Houston, TX, USA.

Abstract

Accumulating evidence underscores the utility of ketamine in treating severely treatment-resistant depressed patients. We investigated the relationship between the rapid antidepressant effects of ketamine and hippocampal volume, a biomarker of antidepressant treatment outcome. We gave 16 medication-free, major depressive disorder (MDD) patients a single, sub-anesthetic dose infusion of ketamine (0.5 mg/kg, over 40 min). We assessed depression severity pre-treatment, and at 24 h post-treatment, with the Montgomery-Åsberg Depression Rating Scale (MADRS). Prior to treatment, patients underwent magnetic resonance imaging (MRI) to estimate their hippocampal volume: We obtained viable MRI data in 13 patients. Delta MADRS (post- minus pre-treatment) was significantly correlated with the pre-treatment volumes of the left hippocampus (r = 0.66; p = 0.01), but not the right hippocampus (r = 0.49; p = 0.09). The correlation between delta MADRS and the left hippocampus remained high (r > 0.6; p = 0.13), after controlling for several demographic and clinical variables, although the p value increased due to the reduced degree of freedom (df = 5). Ketamine exerts enhanced antidepressant effects in patients with a relatively smaller hippocampus, a patient population that has been repeatedly shown to be refractory to traditional antidepressants.

KEYWORDS:

Antidepressant; depression; hippocampus; ketamine; magnetic resonance imaging; major depressive disorder; refractory patients

PMID:
25122038
PMCID:
PMC4852551
DOI:
10.1177/0269881114544776
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center