Patient experience of ketamine for depression: ketamine and me project
Research type
Research Study
Full title
Patient experience of ketamine for depression: 'ketamine and me' project
IRAS ID
270748
Contact name
Chris Griffiths
Contact email
Sponsor organisation
Northamptonshire Healthcare NHS Foundation Trust
Duration of Study in the UK
1 years, 3 months, 13 days
Research summary
Clinical depression is the leading cause of disability worldwide (WHO, 2017). Over 50% of people do not experience remission after first-line antidepressant medication, and one-third do not after four courses of medication (Rush et al. 2006). Between 12%–20% of depressed patients have treatment resistant depression (TRD) (Nemeroff, 2007; Eaton, 2008).
A person is referred to Northamptonshire Healthcare NHS Foundation Trust (NHFT) Neuromodulation Centre for ketamine depression treatment by their GP or psychiatrist. NHFT is one of only two NHS providers of ketamine for TRD.
When used to treat severe depression, evidence indicates that a subanaesthetic ketamine treatment provides a rapid and effective, but short-term, antidepressant action (Kishimoto et al. 2016; Xu et al. 2015), might decrease suicidal ideation (Canuso et al. 2018) and produce a short-term reduction in suicidality (Xu et al. 2015).
Ketamine achieves maximum effect 24 hours after administration, with a gradual decline in effect over seven days. Adverse effects include psychotic and dissociative effects, blood pressure and heart rate fluctuations, blurred vision and drowsiness (Grady et al. 2017). A meta-analysis concluded that ketamine has a rapid onset of antidepressant efficacy when used as monotherapy or in combination with oral antidepressants (Fond et al. 2014).). A review revealed seven RCTs of ketamine in MDD and bipolar disorder concluded ketamine has shown promise in quickly reducing depression symptoms (Grady et al. 2017). Ketamine dependence and withdrawal symptoms have been reported (Morgan & Curran, 2012).
Very little is known about patient experience of ketamine for depression. Over a period of 6 months Neuromodulation patients will be offered the opportunity to participate in research interviews. The aims of this project are to report patient experience and feedback about ketamine treatment and service provision, enhance understanding and to make recommendations for improvements targeted at patients, practitioners, service providers and policy makers.
REC name
East of Scotland Research Ethics Service REC 2
REC reference
19/ES/0123
Date of REC Opinion
8 Oct 2019
REC opinion
Unfavourable Opinion