Lascelles, K.; Marzano, L.; Brand, F.; Trueman, H.; McShane, R.; Hawton, K.

Ketamine treatment for individuals with treatment-resistant depression: a longitudinal qualitative interview study of patient experiences

Article

Lascelles, K., Marzano, L., Brand, F., Trueman, H., McShane, R. and Hawton, K. 2021. Ketamine treatment for individuals with treatment-resistant depression: a longitudinal qualitative interview study of patient experiences. BJPsych Open. 7 (1), pp. 1-8. https://doi.org/10.1192/bjo.2020.132

Publication dates
Type	Article
Title	Ketamine treatment for individuals with treatment-resistant depression: a longitudinal qualitative interview study of patient experiences
Authors	Lascelles, K., Marzano, L., Brand, F., Trueman, H., McShane, R. and Hawton, K.
Abstract	Background Ketamine has recently received considerable attention regarding its antidepressant and anti-suicidal effects. Trials have generally focused on short-term effects of single intravenous infusions. Research on patient experiences is lacking. Aims To investigate the experiences over time of individuals receiving ketamine treatment in a routine clinic, including impacts on mood and suicidality. Method Twelve fee-paying patients with treatment-resistant depression (6 females, 6 males, age 21-70 years; 11 reporting suicidality and six self-harm) who were assessed as eligible for ketamine treatment participated in up to three semi-structured interviews: before treatment started, a few weeks into treatment and two or more months later. Data were analysed thematically. Results Most participants hoped that ketamine would provide respite from their depression. All experienced improvement in mood following initial treatments, ranging from negligible to dramatic, and eight a reduction in suicidality. Improvements were transitory for most participants, although two experienced sustained consistent benefit and two had sustained but limited improvement. Some participants described hopelessness when treatment stopped working, paralleled by increased suicidal ideation for three. The transient nature and cost of treatment were problematic. Eleven participants experienced side-effects, which in two cases were significant. Suggestions for improving treatment included closer monitoring and adjunctive psychological therapy. Conclusions Ketamine treatment was generally experienced as effective in improving mood and reducing suicidal ideation in the short-term, but the lack of longer-term benefit was challenging for participants, as was treatment cost. Informed consent procedures should refer to the possibilities of relapse and of associated increased hopelessness and suicidality.
Keywords	ketamine; treatment-resistant depression; mood; suicidal ideation; side-effects
Research Group	Applied Health Psychology group
Publisher	Cambridge University Press (CUP)
Journal	BJPsych Open
ISSN	2056-4724
Online	07 Dec 2020
Print	01 Jan 2021
Publication process dates
Deposited	23 Oct 2020
Accepted	19 Oct 2020
Output status	Published
Publisher's version	ketamine-treatment-for-individuals-with-treatment-resistant-depression-longitudinal-qualitative-interview-study-of-patient-experiences.pdf License CC BY 4.0
Copyright Statement	Copyright and usage © The Author(s), 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Digital Object Identifier (DOI)	https://doi.org/10.1192/bjo.2020.132
Web of Science identifier	WOS:000596232000001
Language	English

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