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Published on: January 7, 2019
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Nonresponse to Ketamine in Treatment-Resistant Bipolar Depression.
Zofia Kachlik1, Wiesław Jerzy Cubała1, Michał Walaszek1
1Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland.
Neuropsychopharmacology Reports
|August 29, 2025
Summary
Ketamine nonresponse in treatment-resistant bipolar depression (TRBD) was linked to more psychiatric comorbidities and prior benzodiazepine use. Understanding these factors can help optimize ketamine antidepressant therapy.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Ketamine is a rapid-acting antidepressant for treatment-resistant bipolar depression (TRBD).
- Many patients do not achieve a meaningful response to ketamine treatment.
- This study investigated factors associated with ketamine nonresponse in TRBD patients.
Purpose of the Study:
- To explore features distinguishing ketamine nonresponders from responders in TRBD.
- To identify baseline characteristics associated with treatment outcomes.
Main Methods:
- Post hoc analysis of a naturalistic study.
- 35 TRBD patients received a four-week ketamine regimen (IV or oral).
- Response assessed using Montgomery-Åsberg Depression Rating Scale; baseline features compared between responders and nonresponders.
Main Results:
- 40% of patients (14/35) were nonresponders.
- Nonresponders had more psychiatric comorbidities (median 2 vs. 1) and higher rates of any comorbidity (78.6% vs. 33.3%).
- Greater prior benzodiazepine use was observed in nonresponders (64.3% vs. 23.8%).
Conclusions:
- Ketamine shows favorable short-term safety and tolerability in TRBD.
- A higher comorbidity burden and prior benzodiazepine use are associated with ketamine nonresponse.
- These findings may inform personalized treatment strategies for TRBD.
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