Ketamine treatments for depression and anxiety are gaining traction as a viable option, but these treatments have largely been administered inside the lab or doctor’s office. There is now ongoing positive data for a new sublingual ketamine treatment taken at home that is paired with a telehealth appointment at the start of the session. In this study by Thomas D. Hull and Matteo Malgaroli, 1,247 participants between the ages of 19 and 76 (54.6% women) who completed both medication sessions and outcome measurements of the PHQ-9 and GAD-7. For this protocol, participants were given 300 mg to 450 mg dose of sublingual, rapidly dissolving ketamine, along with Ondansetron for nausea. Additionally, participants were given a digital blood pressure cuff, journal, eye mask, and instructions for treatment. Participants are also paired with a guide who is not a trained clinician or therapist but provides an open ear and warm response to any difficulty a person may experience. Finally, participants also have a trusted peer monitor with them for the session that is a family member or friend to ensure the comfort and safety of the participant. The session begins with a short 30 min meeting with their guide before taking the medicine, lying down for an hour, and then journaling for 30 mins. Statistical analyses found 3 subgroups of patients in the study: the improvement group (79.3%), the chronic group (11.4%), and the delayed improvement group (9.3%). The improvement group was defined as showing clinically significant reductions in PHQ-9/GAD-7 scores after the first session, the delayed improvement group showed reductions on these outcome measurements after 2 sessions, and the chronic group never showed improvements. These data found large clinical decreases in depression and anxiety over the four-week treatment period, with only 6 patients dropping out of the study and less than 1% of patients’ symptoms deteriorating. Specifically, 62.8% of depressed patients and 62.9% of anxious patients showed clinically significant improvements with effect sizes of 1.61 and 1.56 respectively. This study highlights the efficacy of ketamine in the treatment of anxiety and depression and more importantly shows that this treatment can take place safely at one’s home.

Reference:

Hull, TD. Matteo, M. et al. J Aff Dis 2022; 314: 59-67 Abstract.