The impact of childhood maltreatment on intravenous ketamine outcomes for adult patients with treatment-resistant depression

Brittany O’Brien, Marijn Lijffijt, Allison Wells, Alan C. Swann, Sanjay J. Mathew

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Childhood maltreatment is associated with a poor treatment response to conventional antidepressants and increased risk for treatment-resistant depression (TRD). The N-methyl-Daspartate receptor (NDMAR) antagonist ketamine has been shown to rapidly improve symptoms of depression in patients with TRD. It is unknown if childhood maltreatment could influence ketamine’s treatment response. We examined the relationship between childhood maltreatment using the Childhood Trauma Questionnaire (CTQ) and treatment response using the Quick Inventory of Depressive Symptoms-Self Report (QIDS-SR) in TRD patients receiving intravenous ketamine at a community outpatient clinic. We evaluated treatment response after a single infusion (n = 115) and a course of repeated infusions (n = 63). Repeated measures general linear models and Bayes factor (BF) showed significant decreases in QIDS-SR after the first and second infusions, which plateaued after the third infusion. Clinically significant childhood sexual abuse, physical abuse, and cumulative clinically significant maltreatment on multiple domains (maltreatment load) were associated with better treatment response to a single and repeated infusions. After repeated infusions, higher load was also associated with a higher remission rate. In contrast to conventional antidepressants, ketamine could be more effective in TRD patients with more childhood trauma burden, perhaps due to ketamine’s proposed ability to block trauma-associated behavioral sensitization.

Original languageEnglish
Article number133
JournalPharmaceuticals
Volume12
Issue number3
DOIs
StatePublished - 2019
Externally publishedYes

Keywords

  • Childhood maltreatment
  • Childhood trauma
  • Depression
  • Ketamine
  • Treatment schedule behavioral sensitization

Fingerprint

Dive into the research topics of 'The impact of childhood maltreatment on intravenous ketamine outcomes for adult patients with treatment-resistant depression'. Together they form a unique fingerprint.

Cite this