Cited by 114Treatment of Major DepressionElectroconvulsive Therapy StudiesBipolar Disorder and Treatment

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Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder

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Rong, Carola, Park, Caroline, Rosenblat, Joshua D., Subramaniapillai, Mehala, Zuckerman, Hannah, Fus, Dominika, Lee, Yena L., Pan, Zihang, Brietzke, Elisa, Mansur, Rodrigo B., Cha, Danielle S., Lui, Leanna M. W., McIntyre, Roger S.·2018·International Journal of Environmental Research and Public Health

DOI 10.3390/ijerph15040771PMC PMC5923813

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Abstract

Objectives: Extant evidence indicates that ketamine exerts rapid antidepressant effects in treatment-resistant depressive (TRD) symptoms as a part of major depressive disorder (MDD) and bipolar disorder (BD). The identification of depressed sub-populations that are more likely to benefit from ketamine treatment remains a priority. In keeping with this view, the present narrative review aims to identify the pretreatment predictors of response to ketamine in TRD as part of MDD and BD. Method: Electronic search engines PubMed/MEDLINE, ClinicalTrials.gov, and Scopus were searched for relevant articles from inception to January 2018. The search term ketamine was cross-referenced with the terms depression, major depressive disorder, bipolar disorder, predictors, and response and/or remission. Results: Multiple baseline pretreatment predictors of response were identified, including clinical (i.e., Body Mass Index (BMI), history of suicide, family history of alcohol use disorder), peripheral biochemistry (i.e., adiponectin levels, vitamin B12 levels), polysomnography (abnormalities in delta sleep ratio), neurochemistry (i.e., glutamine/glutamate ratio), neuroimaging (i.e., anterior cingulate cortex activity), genetic variation (i.e., Val66Met BDNF allele), and cognitive functioning (i.e., processing speed). High BMI and a positive family history of alcohol use disorder were the most replicated predictors. Conclusions: A pheno-biotype of depression more, or less likely, to benefit with ketamine treatment is far from complete. Notwithstanding, metabolic-inflammatory alterations are emerging as possible pretreatment response predictors of depressive symptom improvement, most notably being cognitive impairment. Sophisticated data-driven computational methods that are iterative and agnostic are more likely to provide actionable baseline pretreatment predictive information.

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Authors: Rong, C., Park, C., Rosenblat, J. D., Subramaniapillai, M., Zuckerman, H., Fus, D., Lee, Y. L., Pan, Z., Brietzke, E., Mansur, R. B., Cha, D. S., Lui, L. M. W., & McIntyre, R. S.
Affiliations: University Health Network (CA)
Corresponding author: McIntyre, Roger S.
ORCID: Rong, Carola
Park, Caroline
Rosenblat, Joshua D.
Subramaniapillai, Mehala
Fus, Dominika
Lee, Yena L.
Pan, Zihang
Brietzke, Elisa
Mansur, Rodrigo B.
Lui, Leanna M. W.
McIntyre, Roger S.
Venue: International Journal of Environmental Research and Public Health
Publisher: MDPI AG
Published: 2018-04-17
Volume: 15
Issue: 4
Pages: 771
ISSN: 1660-4601 (ISSN-L)
DOI: 10.3390/ijerph15040771
PMC: PMC5923813
OpenAlex: W2802678418
Cited by: 114
References: 48
Citations by year: 2026: 6 · 2025: 18 · 2024: 14 · 2023: 15 · 2022: 17 · 2021: 18 · 2020: 17 · 2019: 7 · 2018: 2
FWCI: 1.28
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
TSpace (University of Toronto) (submittedVersion, cc-by)
RePEc: Research Papers in Economics (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords: ketamine, treatment-resistant depression, major depressive disorder, bipolar disorder, predictors of treatment response, body mass index, family history of alcoholism, adiponectin, vitamin B12, glutamine/glutamate ratio, anterior cingulate cortex, processing speed, cognitive impairment
MeSH terms: Antidepressive Agents, Bipolar Disorder, Depressive Disorder, Major, Major Depressive Disorder, Humans, Ketamine, Treatment Outcome, Excitatory Amino Acid Antagonists, Depressive Disorder, Treatment-Resistant

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Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder

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