Identifying Patients with Major Depression who Benefit from Ketamine Therapy

Over the last few years, ketamine has been studied as a possible treatment option for Major Depressive Disorder (MDD) and TRD. Ketamine is an NMDA receptor antagonist that targets the glutaminergic system and produces rapid antidepressant effects from mechanisms that are still incompletely defined.5 In March 2019, the FDA approved intranasal esketamine, an enantiomer of ketamine, as a treatment for those who have failed at least two antidepressant medications.6The approval of esketamine as a treatment option for major depressive disorder is considered a significant breakthrough in psychiatric medicine and provides promise for the future of depression management. Nonetheless, the effects from treating TRD with ketamine are not fully characterized or known. For that reason, identifying patients and other factors associated with an increased likelihood of success with esketamine would not only expand the knowledge base, but also limit potential adverse effects from treating persons who are not likely to benefit. These factors might include age, symptom severity, comorbid psychiatric disorders, route of drug administration, drug formulation et cetera. Moreover, examining the different TRD patient populations who experience benefits from esketamine/ketamine therapy would aid in determining who are most likely to benefit from it