Antisuicidal Response Following Ketamine Infusion Is Associated With Decreased Nighttime Wakefulness in Major Depressive Disorder and Bipolar Disorder

Jennifer L Vande Voort; Elizabeth D Ballard; David A Luckenbaugh; Rebecca A Bernert; Erica M Richards; Mark J Niciu; Lawrence T Park; Rodrigo Machado-Vieira; Wallace C Duncan Jr; Carlos A Zarate Jr

doi:10.4088/jcp.15m10440

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Antisuicidal Response Following Ketamine Infusion Is Associated With Decreased Nighttime Wakefulness in Major Depressive Disorder and Bipolar Disorder

Journal article

Open access

Peer reviewed

Antisuicidal Response Following Ketamine Infusion Is Associated With Decreased Nighttime Wakefulness in Major Depressive Disorder and Bipolar Disorder

Jennifer L Vande Voort, Elizabeth D Ballard, David A Luckenbaugh, Rebecca A Bernert, Erica M Richards, Mark J Niciu, Lawrence T Park, Rodrigo Machado-Vieira, Wallace C Duncan Jr and Carlos A Zarate Jr

The journal of clinical psychiatry, Vol.78(8), pp.1068-1074

09/2017

DOI: 10.4088/jcp.15m10440

PMCID: PMC5641476

PMID: 27929610

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https://www.ncbi.nlm.nih.gov/pmc/articles/5641476View

Open Access

Abstract

Insomnia and disrupted sleep are associated with increased risk of suicide. The N-methyl-d-aspartate antagonist ketamine has been associated with reduced suicidal thoughts, but the mechanism of action is unknown. This study sought to evaluate differences in nocturnal wakefulness in depressed individuals who did and did not have an antisuicidal response to ketamine. Thirty-four participants with baseline suicidal ideation diagnosed with either DSM-IV major depressive disorder (n = 23) or bipolar depression (n = 11) between 2006 and 2013 completed nighttime electroencephalography (EEG) the night before and the night after a single ketamine infusion (0.5 mg/kg over 40 minutes). Suicidal ideation was assessed at baseline and the morning after ketamine infusion via several measures, including the Hamilton Depression Rating Scale suicide item, the suicide item of the Montgomery-Asberg Depression Rating Scale, and the first 5 items of the Scale for Suicide Ideation. A generalized linear mixed model evaluated differences in nocturnal wakefulness, as verified by EEG, between those who had an antisuicidal response to ketamine and those who did not, controlling for baseline nocturnal wakefulness. Results were also compared to the sleep of healthy controls (n = 22). After analyses adjusted for baseline sleep, participants with an antisuicidal response to ketamine showed significantly reduced nocturnal wakefulness the night after ketamine infusion compared to those without an antisuicidal response (F₁,₂₂ = 5.04, P = .04). Level of nocturnal wakefulness after antisuicidal response to ketamine did not differ significantly from nocturnal wakefulness in the control sample but did differ at a trend level (F₁,₄₀ = 3.15, P = .08). Reductions in wakefulness following ketamine may point to a biological mechanism underlying the effect of ketamine on suicidal ideation. ClinicalTrials.gov identifier: NCT00088699.

Drug Resistance

Wakefulness - drug effects

Humans

Middle Aged

Suicide - prevention & control

Male

Suicidal Ideation

Drug Monitoring - methods

Bipolar Disorder - diagnosis

Ketamine - administration & dosage

Ketamine - adverse effects

Psychiatric Status Rating Scales

Suicide - psychology

Adult

Female

Excitatory Amino Acid Antagonists - adverse effects

Depressive Disorder, Major - drug therapy

Diagnostic and Statistical Manual of Mental Disorders

Excitatory Amino Acid Antagonists - administration & dosage

Bipolar Disorder - complications

Depressive Disorder, Major - complications

Treatment Outcome

Bipolar Disorder - drug therapy

Electroencephalography - methods

Bipolar Disorder - psychology

Depressive Disorder, Major - psychology

Administration, Intravenous

Depressive Disorder, Major - diagnosis

Details

Title: Subtitle: Antisuicidal Response Following Ketamine Infusion Is Associated With Decreased Nighttime Wakefulness in Major Depressive Disorder and Bipolar Disorder
Creators: Jennifer L Vande Voort - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Elizabeth D Ballard - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
David A Luckenbaugh - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Rebecca A Bernert - Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
Erica M Richards - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Mark J Niciu - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Lawrence T Park - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Rodrigo Machado-Vieira - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Wallace C Duncan Jr - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Carlos A Zarate Jr - Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Resource Type: Journal article
Publication Details: The journal of clinical psychiatry, Vol.78(8), pp.1068-1074
DOI: 10.4088/jcp.15m10440
PMID: 27929610
PMCID: PMC5641476
NLM abbreviation: J Clin Psychiatry
ISSN: 0160-6689
eISSN: 1555-2101
Publisher: United States
Grant note: ZIA MH002857-12 / Intramural NIH HHS K23 MH093490 / NIMH NIH HHS
Language: English
Date published: 09/2017
Academic Unit: Psychiatry; Iowa Neuroscience Institute
Record Identifier: 9984004180502771

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