Ketamine in the treatment of Treatment Resistant Depression

The goal of this project is to better understand how different treatment frameworks affect both short- and long-term outcomes in ketamine treatment for treatment-resistant depression.

The prevalence of depression world-wide is approximately 6% and it is one of the leading reasons for functional disability. Although estimates vary, 11 up to 30% of patients end up with treatment-resistant depression (TRD).

Administration of intravenous ketamine is being used for the treatment of TRD, and a significant number of patients benefit, although results are not always long-lasting.

A comparison between two models

We will compare the traditional ketamine-treatment model with the novel Montreal-model.

In the traditional model, the neurobiological properties of ketamine are believed to convey the therapeutic effect and the acute subjective effects of ketamine are considered as adverse side-effects.

The Montreal-model integrates findings from psychedelic research where the subjective effects are considered possible mediators of the therapeutic effect.

Ketamine-induced experiences may offer the possibility for introspection and deeper self-knowledge and lead to more long-term and sustainable antidepressant effects, similarly to psychedelic substances.

Therefore, we will evaluate the effect of the therapeutic framework on the treatment outcome of ketamine therapy for TRD, systematically characterize the acute subjective experiences during ketamine treatment and investigate the role of the experiences in mediating the short- and long-term treatment outcome.

Collaborating partners

This RCT study is MD Alexandra Leinonen’s PhD project, supervised in collaboration with Prof. Rajna Knez (University of Gothenburg, University of Skövde, and Skaraborg Hospital), MD/PhD Valdemar Landgren (University of Gothenburg, Skaraborg Hospital) and Katja Valli (University of Skövde).