Does body mass index predict response to intravenous ketamine treatment in adults with major depressive and bipolar disorder? Results from the Canadian Rapid Treatment Center of Excellence

Abstract

Background Higher body mass index (BMI) has been found to predict greater antidepressant response to intravenous (IV) ketamine treatment. We evaluated the association between BMI and response to repeat-dose IV ketamine in patients with treatment-resistant depression (TRD). Methods Adults (N = 230) with TRD received four infusions of IV ketamine at a community-based clinic. Changes in symptoms of depression (ie, Quick Inventory for Depressive Symptomatology-Self-Report 16; QIDS-SR16), suicidal ideation (SI; ie, QIDS-SR16 SI item), anxiety (ie, Generalized Anxiety Disorder-7 Scale), anhedonic severity (ie, Snaith–Hamilton Pleasure Scale), and functioning (ie, Sheehan Disability Scale) following infusions were evaluated. Participants were stratified by BMI as normal (18.0-24.9 kg/m2; n = 72), overweight (25-29.9 kg/m2; n = 76), obese I (30-34.9 kg/m2; n = 47), or obese II (≥35.0 kg/m2; n = 35). Results Similar antidepressant effects with repeat-dose ketamine were reported between BMI groups (P = .261). In addition, categorical partial response (P = .149), response (P = .526), and remission (P = .232) rates were similar between the four BMI groups. Conclusions The findings are limited by the observational, open-label design of this retrospective analysis. Pretreatment BMI did not predict response to IV ketamine, which was effective regardless of BMI.

Conceptualising centres of excellence: a scoping review of global evidence

“…CoE is a team of specialised expertise2 7 17 24–47 or organisational environment2 5 24 30 35 36 48–56 that is established to provide outstanding healthcare,2 7 12 17 24–39 41 48 50 51 57–74 research,12 17 24 26–28 31 36 40 41 50 52 58 68 72 74–85 education and training,12 17 24 25 31 36 38 42 43 68 73 74 76 81–83 85–88 regulatory,57 83 89 policy,46 49 54 55 82 90 information technology45 53 91 or industrial44 92 93 services and support in high levels of efficient and effective performance. CoEs are geographically concentrated and focused on high potential in science and industry,46 as a world leader or a catalyst between neighbouring countries,60 72 82 anywhere from the local research and development (R&D) group up to a network of cooperative partners.…”

“…In the healthcare sector, CoEs can provide breakthrough treatments on specific disease conditions 26–33. In line with the current COVID-19 pandemic, some hospitals and universities have established COVID-19-specific CoEs 24 96…”

“…12 81 95 In the healthcare sector, CoEs can provide breakthrough treatments on specific disease conditions. [26][27][28][29][30][31][32][33] In line with the current COVID-19 pandemic, some hospitals and universities have established COVID-19-specific CoEs. 24 96 CoE could be established to provide specific regulatory decision making, including to advance the development and regulation of products 25 83 and to fill in knowledge gaps.…”

A computational model to characterize the time-course of response to rapid antidepressant therapies

“…Many investigations are being undertaken to identify predictors of ketamine's antidepressant effects, given the rapidly widespread use of this treatment modality [19,20]. Several predictors of response to ketamine have been identified, including intra-infusion dissociation [21], fewer treatment failures [22], family history of alcohol dependence [23], anhedonic or interest-activity symptoms [24], obesity [25], and mixed/anxious features of depression [26]. Electroencephalographic markers have also been identified, most notably increases in gamma power [20].…”

The role of ketamine in the treatment of treatment-resistant bipolar depression

“…Υπάρχουν αναφορές που συσχετίζουν τον υψηλότερο δείκτη μάζας σώματος (BMI) με τη μεγαλύτερη αντικαταθλιπτική απάντηση στην IV χορηγούμενη κεταμίνη σε περιπτώσεις ΔΚ. 35…”