Ketamine Alleviates Depressive Symptoms in Patients Undergoing Intracranial Tumor Resection: A Randomized Controlled Trial.

Ketamine Alleviates Depressive Symptoms in Patients Undergoing Intracranial Tumor Resection: A Randomized Controlled Trial.

Publication date: Oct 11, 2021

Depressive symptoms occur in over 40% of neurosurgical patients during the perioperative period. However, no measure has been suggested to have a rapid effect on depressive surgical patients during increasingly shorter stays in the hospital. This study aimed to determine whether ketamine could improve depressive symptoms rapidly and safely during the hospital stay. This was a randomized, placebo-controlled, and double-blinded trial. Patients with moderate-to-severe depressive symptoms undergoing elective supratentorial brain tumor resection were randomized to intravenously receive either (1) 0. 5 mg.kg-1 ketamine for 40 minutes or (2) an identical volume of normal saline. The primary outcome was treatment response on postoperative day 3, defined as a ≥50% reduction from the baseline depressive score. The secondary outcomes included the rate of remission and safety outcomes. The Montgomery-Asberg Depression Rating Scale was applied by trained psychiatrists to evaluate depressive symptoms. A total of 84 neurosurgical patients were enrolled in the trial. The response rate was increased by the administration of ketamine (41. 5% [17/41] vs 16. 3% [7/43]; relative risk [RR]: 2. 51, 95% confidence interval [CI], 1. 18-5. 50) relative to the administration of placebo at 3 days. Furthermore, the remission rate at discharge (29. 3% [12/41] vs 7. 0% [3/43]; RR: 4. 20, 95% CI, 1. 28-13. 80) was also improved by ketamine. No psychotic symptoms or adverse events were reported to be substantially higher in the ketamine group. The trial indicates that the intraoperative administration of ketamine could alleviate moderate-to-severe depressive symptoms in neurosurgical patients without worsening safety.

Concepts Keywords
Drugs Psychosis
Increased Sedatives
Postoperative Ketamine
Psychiatrists NMDA receptor antagonists
Tumor Antidepressants
Euphoriants
Neurochemistry
Psychoactive drugs
Major depressive disorder
Management of depression

Semantics

Type Source Name
drug DRUGBANK Ketamine
disease MESH Depressive Symptoms
disease MESH Tumor
disease MESH brain tumor

Original Article

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