Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials

Elizabeth D Ballard; Kathleen Wills; Níall Lally; Erica M Richards; David A Luckenbaugh; Tessa Walls; Rezvan Ameli; Mark J Niciu; Nancy E Brutsche; Lawrence Park; Carlos A Zarate

doi:10.1016/j.jad.2017.04.057

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Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials

Journal article

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Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials

Elizabeth D Ballard, Kathleen Wills, Níall Lally, Erica M Richards, David A Luckenbaugh, Tessa Walls, Rezvan Ameli, Mark J Niciu, Nancy E Brutsche, Lawrence Park, …

Journal of affective disorders, Vol.218, pp.195-200

08/15/2017

DOI: 10.1016/j.jad.2017.04.057

PMCID: PMC5515296

PMID: 28477497

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Abstract

Identifying clinical correlates associated with reduced suicidal ideation may highlight new avenues for the treatment of suicidal thoughts. Anhedonia occurs across psychiatric diagnoses and has been associated with specific neural circuits in response to rapid-acting treatments, such as ketamine. This analysis sought to evaluate whether reductions in suicidal ideation after ketamine administration were related to reduced levels of anhedonia, independent of depressive symptoms. This post-hoc analysis included treatment-resistant patients with either major depressive disorder (MDD) or bipolar disorder (BD) from several clinical trials of ketamine. Anhedonia was assessed using a subscale of the Beck Depression Inventory (BDI) and the Snaith-Hamilton Pleasure Scale (SHAPS). The outcome of interest was suicidal ideation, as measured by a subscale of the Scale for Suicide Ideation (SSI5), one day post-ketamine administration. Anhedonia, as measured by the SHAPS, was associated with suicidal thoughts independent of depressive symptoms both before and after ketamine administration. One day post-ketamine administration, improvements on the SHAPS accounted for an additional 13% of the variance in suicidal thought reduction, beyond the influence of depressive symptoms. The BDI anhedonia subscale was not significantly associated with suicidal thoughts after adjusting for depressive symptoms. Data were limited to patients experiencing a major depressive episode and may not be generalizable to patients experiencing an active suicidal crisis. Suicidal thoughts may be related to symptoms of anhedonia independent of other depressive symptoms. These results have implications for the potential mechanisms of action of ketamine on suicidal thoughts. •Ketamine has been associated with rapid reductions in suicidal thoughts.•Ketamine has also been associated with reductions in anhedonia.•Ketamine's anti-suicidal effects may be due to its ability to reduce anhedonia.•Anhedonia may be an important research and treatment target for suicidal thoughts.

RDoC

Anhedonia

Depression

Ketamine

Suicide

Details

Title: Subtitle: Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials
Creators: Elizabeth D Ballard - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Kathleen Wills - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Níall Lally - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Erica M Richards - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
David A Luckenbaugh - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Tessa Walls - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Rezvan Ameli - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Mark J Niciu - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Nancy E Brutsche - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Lawrence Park - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Carlos A Zarate - Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
Resource Type: Journal article
Publication Details: Journal of affective disorders, Vol.218, pp.195-200
DOI: 10.1016/j.jad.2017.04.057
PMID: 28477497
PMCID: PMC5515296
NLM abbreviation: J Affect Disord
ISSN: 0165-0327
eISSN: 1573-2517
Publisher: Elsevier B.V
Language: English
Date published: 08/15/2017
Academic Unit: Psychiatry; Iowa Neuroscience Institute
Record Identifier: 9984003991102771

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