Association of anhedonia and suicidal ideation in patients with treatment-refractory depression after intravenous ketamine infusions

• Published in: International journal of psychiatry in clinical practice 2023-06, Vol.27 (2), p.145-150
• Main Authors: Zheng, Wei, Gu, Li-Mei, Yang, Xin-Hu, Zhou, Yan-Ling, Wang, Cheng-Yu, Lan, Xiao-Feng, Zhang, Bin, Ning, Yu-Ping
• Format: Article
• Language: English
• Subjects: Anhedonia; clinical trial; depression; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Depressive Disorder, Treatment-Resistant - drug therapy; Humans; Ketamine; Ketamine - adverse effects; Montgomery-Åsberg Depression Rating Scale; Psychiatric Status Rating Scales; Suicidal Ideation
• ISSN: 1365-1501; 1471-1788
• DOI: 10.1080/13651501.2022.2138444

Accumulating evidence suggests that the effects of ketamine administered intravenously at subanaesthetic doses on both anhedonic symptoms and suicidal ideation occur independently of depressive symptoms in major depressive disorder (MDD) and bipolar disorder (BD). This study sought to determine the relationship between anhedonia and suicidal ideation after serial ketamine infusions. A total of 79 subjects with either treatment-refractory MDD (n = 60) or BD (n = 19) were included in a clinical ketamine study. The Montgomery-Åsberg Depression Rating Scale (MADRS) anhedonia factor and the first five items of the Scale for Suicidal Ideations (SSI-Part I) were used to assess anhedonia symptoms and suicidal ideation, respectively. At baseline, anhedonia, as measured by the MADRS, was not significantly associated with suicidal ideation or specific suicide-related ideation as measured by SSI-Part I (all p's > 0.05). Only the 'wish to die' and 'desire to make a suicide attempt' items were positively associated with anhedonia at two weeks after the sixth ketamine infusion, which was independent of the reductions in depressive symptoms (all p's