부산대학교 도서관

Introduction: Major depressive disorder affects approximately 300 million people globally. Standard antidepressants lack effectiveness for 21% of patients - resulting in treatmentresistant depression (TRD). Ketamine acts through unique physiological mechanisms with estimated response rates of 50-60% in TRD. In 2018, we established the first publicly accessible ketamine clinic in southeastern Ontario for TRD at Providence Care Hospital. Objectives: Our primary objective is to determine the efficacy of an acute ketamine treatment (0.5 mg/kg) for patients with TRD. Our secondary objective is to increase evidence by identifying biomarkers associated with treatment responders. We hypothesize that intravenous ketamine will successfully treat TRD, improving patient outcomes. Methods: There are pre, weekly, and post-assessments to measure patient progress including mood symptoms, disability, quality of life, and cognition (e.g. MADRS, BPRS, CADSS, YMRS, etc). Eligible patients receive ketamine three times/week for two weeks, and twice/week for two weeks. Blood is collected at three-time points, and ELISA assays will be conducted on isolated plasma to measure biomarkers. Results: Patients (n=8) show a mean reduction of MADRS score of 23.25 after just two weeks, or a 58.6% improvement in depressive symptoms. After four weeks, depressive symptoms continue to improve, resulting in a mean 66.8% improvement. Increases in manic symptoms or psychiatric symptoms are not observed post-ketamine. Conclusions: We expect ketamine to continue successfully treating patients with TRD. Future goals of our clinic include quantifying biomarkers such as BDNF, inflammatory markers, and irisin to develop personalized interventions for TRD, recognizing that one treatment may not be effective for all patients. [ABSTRACT FROM AUTHOR]