Eggers, C.E. (Charlotte) (2021) Antidepressant efficacy of oral esketamine in treatment resistant depression is not dose-dependent. thesis, Medicine.
Full text available on request.Abstract
Background: Major depressive disorder (MDD) is a global burden that reduces the quality of life of those suffering from it, and results in substantial financial costs in health care services. Ketamine has been shown to be a rapid and effective antidepressant, even for patients who are otherwise treatment resistant to conventional antidepressants. Different routes of administration have shown promising results, as well as the usage of esketamine. This study investigated the dose-response relationship of oral esketamine for patients suffering from treatment resistant depression (TRD). Methods: 63 patients, with TRD were given individually adjusted doses of oral esketamine twice a week for 6 weeks in an open-label setting. Based on the dose they were given at the end of the treatment, two dose-groups were differentiated: patients receiving ≤ 2 mg/kg and patients receiving up to 3,5 mg/kg oral esketamine. The Hamilton Depression Rating Scale (HDRS) was used to determine a reduction of depressive symptoms after the treatment and applied as a measurement to compare the two dose groups. Differences in side-effects between the groups were assessed with the Systematic Assessment for Treatment Emergent Events (SAFTEE) and the Montreal Cognitive Assessment (MoCA). Results: The group receiving ≤ 2 mg/kg, had a mean decrease in HDRS score by 27,14 %, while the group receiving up to 3,5 mg/kg oral esketamine had a 24,96 % decrease in mean HDRS score. No significant difference in efficacy between the two dose groups was observed. Adverse effects such as dizziness, dissociation, blurry vision and cognitive impairment were observed in both groups, but they were not related to the dose given. Conclusion: No significant dose-response relationship of oral esketamine as an antidepressant was observed in this study. Further studies will have to be conducted to establish clinical implications, such as the therapeutic window, of this treatment.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Schoevers, prof. dr. R. and Smith-Apeldoorn, drs. S. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 10:17 |
| Last Modified: | 07 Jan 2022 10:17 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2994 |
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