Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
Canadian Rapid Treatment Center of Excellence, Mississauga, Ontario, Canada.
CNS Spectr. 2022 Jun;27(3):322-330. doi: 10.1017/S1092852920002102. Epub 2020 Dec 3.
Higher body mass index (BMI) has been found to predict greater antidepressant response to intravenous (IV) ketamine treatment. We evaluated the association between BMI and response to repeat-dose IV ketamine in patients with treatment-resistant depression (TRD).
Adults (N = 230) with TRD received four infusions of IV ketamine at a community-based clinic. Changes in symptoms of depression (ie, Quick Inventory for Depressive Symptomatology-Self-Report 16; QIDS-SR16), suicidal ideation (SI; ie, QIDS-SR16 SI item), anxiety (ie, Generalized Anxiety Disorder-7 Scale), anhedonic severity (ie, Snaith-Hamilton Pleasure Scale), and functioning (ie, Sheehan Disability Scale) following infusions were evaluated. Participants were stratified by BMI as normal (18.0-24.9 kg/m2; n = 72), overweight (25-29.9 kg/m2; n = 76), obese I (30-34.9 kg/m2; n = 47), or obese II (≥35.0 kg/m2; n = 35).
Similar antidepressant effects with repeat-dose ketamine were reported between BMI groups (P = .261). In addition, categorical partial response (P = .149), response (P = .526), and remission (P = .232) rates were similar between the four BMI groups.
The findings are limited by the observational, open-label design of this retrospective analysis. Pretreatment BMI did not predict response to IV ketamine, which was effective regardless of BMI.
较高的体重指数（BMI）已被发现可预测静脉（IV）氯胺酮治疗的抗抑郁反应更大。我们评估了 BMI 与治疗抵抗性抑郁症（TRD）患者重复剂量 IV 氯胺酮反应之间的关系。
在社区诊所接受 IV 氯胺酮治疗的 TRD 成年患者（N=230）接受了四剂 IV 氯胺酮治疗。评估了以下情况下的抑郁症状变化（即，抑郁症状快速清单自评量表 16 项；QIDS-SR16）、自杀意念（即，QIDS-SR16 SI 项）、焦虑（即，广泛性焦虑障碍-7 量表）、快感缺失严重程度（即，Snaith-Hamilton 快感量表）和功能（即，Sheehan 残疾量表）。根据 BMI 将参与者分层为正常（18.0-24.9kg/m2；n=72）、超重（25-29.9kg/m2；n=76）、肥胖 I（30-34.9kg/m2；n=47）或肥胖 II（≥35.0kg/m2；n=35）。
重复剂量氯胺酮的抗抑郁作用在 BMI 组之间相似（P=0.261）。此外，四类 BMI 组之间的分类部分反应（P=0.149）、反应（P=0.526）和缓解（P=0.232）率相似。
这些发现受到回顾性分析的观察性、开放标签设计的限制。治疗前 BMI 不能预测 IV 氯胺酮的反应，无论 BMI 如何，氯胺酮都有效。
