Study, Nov/23: Intravenous ketamine for benzodiazepine deprescription and withdrawal management in treatment-resistant depression: a preliminary report

[[La...]]

 

Intravenous ketamine for benzodiazepine deprescription and withdrawal management in treatment-resistant depression: a preliminary report

https://pubmed.ncbi.nlm.nih.gov/37532888/

 

Abstract

We present the first evidence that sub-anesthetic ketamine infusions for treatment resistant depression (TRD) may facilitate deprescription of long-term benzodiazepine/z-drugs (BZDRs). Long-term BZDR prescriptions are potentially harmful yet common, partly because of challenging withdrawal symptoms. Few pharmacological interventions have evidence for facilitating BZDR discontinuation, and none in patients actively suffering from TRD. In this ambi-directional cohort study, discontinuation of long-term (>6 month) BZDRs was attempted in 22 patients with severe unipolar or bipolar TRD receiving a course of six subanesthetic ketamine infusions over four weeks. We investigated the rates of successful BZDRs deprescription, trajectories of acute psychological withdrawal symptoms, and subsequent BZDRs abstinence during a mean follow-up of 1 year (primary outcome). Clinically significant deteriorations in depression, anxiety, sleep, and/or suicidality during the acute BZDR discontinuation phase were measured by repeated standardized scales and analyzed by latent growth curve models and percent correct classification analysis. Of the 22 eligible patients, all enrolled in this study and 91% (20/22) successfully discontinued all BZDRs by the end of the 4-week intervention, confirmed by urinary analyses. Less than 25% of discontinuers experienced any significant worsening of anxiety, depression, sleep difficulties, or suicidality during treatment. During follow-up (mean [range] duration, 12 [3-24] months), 64% (14/22) of patients remained abstinent from any BZDRs. These preliminary results suggest that ketamine infusions for TRD may facilitate the deprescription of BZDRs, even in patients with active depressive symptoms and significant comorbidity. Further investigation is warranted into this potential novel application of ketamine.

Full Paper:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579413/

 

 

 

[[...]]

On 07/09/2024 at 12:12, [[L...] said:

Intravenous ketamine for benzodiazepine deprescription and withdrawal management in treatment-resistant depression: a preliminary report

https://pubmed.ncbi.nlm.nih.gov/37532888/

Abstract

We present the first evidence that sub-anesthetic ketamine infusions for treatment resistant depression (TRD) may facilitate deprescription of long-term benzodiazepine/z-drugs (BZDRs). Long-term BZDR prescriptions are potentially harmful yet common, partly because of challenging withdrawal symptoms. Few pharmacological interventions have evidence for facilitating BZDR discontinuation, and none in patients actively suffering from TRD. In this ambi-directional cohort study, discontinuation of long-term (>6 month) BZDRs was attempted in 22 patients with severe unipolar or bipolar TRD receiving a course of six subanesthetic ketamine infusions over four weeks. We investigated the rates of successful BZDRs deprescription, trajectories of acute psychological withdrawal symptoms, and subsequent BZDRs abstinence during a mean follow-up of 1 year (primary outcome). Clinically significant deteriorations in depression, anxiety, sleep, and/or suicidality during the acute BZDR discontinuation phase were measured by repeated standardized scales and analyzed by latent growth curve models and percent correct classification analysis. Of the 22 eligible patients, all enrolled in this study and 91% (20/22) successfully discontinued all BZDRs by the end of the 4-week intervention, confirmed by urinary analyses. Less than 25% of discontinuers experienced any significant worsening of anxiety, depression, sleep difficulties, or suicidality during treatment. During follow-up (mean [range] duration, 12 [3-24] months), 64% (14/22) of patients remained abstinent from any BZDRs. These preliminary results suggest that ketamine infusions for TRD may facilitate the deprescription of BZDRs, even in patients with active depressive symptoms and significant comorbidity. Further investigation is warranted into this potential novel application of ketamine.

Full Paper:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579413/

Has anyone in BB tried this ?? 

[[Na...]]

[[Pr...]]

1 hour ago, [[N...] said:

I have. Probably a half dozen times in a clinic that specializes in ketamine infusions.

They were interesting experiences, but no magic bullet. But I tried this years after my taper was completed. Perhaps a different person or someone at a different stage would have better luck.

I’d be happy to answer any question I can.

I did 7 infusions in a matter of 2-3 weeks when my acute withdrawals were at their worst. After it wore off, I was back into acute withdrawal. If they could hook me up 24/7 to the IV it would have been more helpful.

I'm in my first week of restarting my taper after stabilizing but I have not done any ketamine infusions since.

[[...]]

Thank you both for your input. For myself personally I don't think I will be trying this. My mind feels way too fragile for any kind of psychedelic type anything and I'm too scared to introduce anything that could tilt me physically possibly any worse than I already am. Maybe after I'm off I would try it for grief or depression but being off or healed seems like a distant future from where I sit today. If anyone else tries this plz add to the thread though it is interesting to see possibilities and all experiences