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Efficacy of Ketamine with and without Lamotrigine in Treatment-Resistant Depression


Intravenous (IV) ketamine and intranasal (IN) esketamine have both been increasingly utilized in managing treatment-resistant depression (TRD). Previous studies have hinted at a synergistic impact of ketamine when combined with lamotrigine, but the evidence has been inconclusive. Boney Joseph et al. set out to explore the response to ketamine/esketamine treatment with or without lamotrigine in patients suffering from TRD.


A Historical Cohort Study

A historical cohort study evaluated adult patients with TRD who received either serial IV racemic ketamine or IN esketamine treatments. The 16-item Quick Inventory of Depressive Symptomatology self-report (QIDS-SR) scale was used to measure the change in depressive symptoms. No significant differences were observed in response or remission rates between patients on lamotrigine or not during the ketamine/esketamine treatments. A noticeable trend, however, featured lower dissociation (based on the CADSS score) among lamotrigine users, especially in patients who received IV ketamine. This trend suggests that lamotrigine therapy may at least attenuate dissociation in patients receiving serial ketamine treatments.


Positive Sentiment Around New Treatment Option

It's worth noting that this preliminary study provides insufficient evidence to confirm whether continuing lamotrigine therapy truly impacts the antidepressant effect of repeated ketamine/esketamine. Seeing as one of this study's major limitations was the small number of patients taking lamotrigine (n=13), further research is required to corroborate these findings.

Nevertheless, the results give us a lot to be optimistic about! Ketamine and esketamine have shown promise in addressing TRD, and this study contributes to the growing body of evidence that highlights their potential.


Hot Take

Limitations aside, this research reveals intriguing results that warrant further exploration. Professionals in the medical industry should keep an eye on this potential new treatment option for TRD

This post was written based on content from this original Article

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