Sustained improvement of negative self-schema after a single ketamine infusion: an open-label study

Hasler, Gregor; Suker, Samir; Schoretsanitis, Georgios; Mihov, Yoan

doi:10.3389/fnins.2020.00687

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Journal article

Sustained improvement of negative self-schema after a single ketamine infusion: an open-label study

Hasler, Gregor Psychiatry Research Unit, University of Fribourg, Villars-sur-Glâne, Switzerland - Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
Suker, Samir Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
Schoretsanitis, Georgios Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
Mihov, Yoan Psychiatry Research Unit, University of Fribourg, Villars-sur-Glâne, Switzerland - Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland

01.07.2020

Published in:

Frontiers in Neuroscience. - 2020, vol. 14, p. 687

English Conventional antidepressants have several important limitations, including a lack of direct effects on negative self-schema, which is at the core of Beck’s cognitive theory of depression. Based on previous studies showing a positive effect of ketamine on negative cognition, we compared reductions in negative self-schema between responders and non-responders to a single infusion of ketamine. In an open-label study, 26 participants with treatment-resistant depression received 0.5 mg/kg ketamine via infusion. Depression symptoms were assessed at baseline, 24 hours, and seven days after treatment with Montgomery-Åsberg Depression Rating Scale (MADRS) and Beck Depression Inventory (BDI-II). Nine of the 26 participants fulfilled response criteria after 24 hours. Of these, eight still fulfilled response criteria after seven days. Response was defined as a reduction in MADRS total score of 50% or more. Responders improved significantly more than non-responders both 24 hours and seven days after ketamine treatment on the following BDI-II items: item 1 (“Sadness”), item 7 (“Self-Dislike”), and item 8 (“Self-Criticalness”). These results suggest an important therapeutic effect of ketamine on negative self-schema, which is a fundamental cognitive aspect of depression. This effect is unique and might be associated with ketamine’s profound effects on neuroplasticity. Small sample size and lack of a placebo control group are the major limitations of this study.

Faculty

Faculté des sciences et de médecine

Department

Master en médecine

Language