At-home sublingual ketamine therapy has shown to be a safe and effective treatment for anxiety and depression, according to a recent, large-scale study.

The researchers studied a cohort of 1247 outpatients who received ketamine therapy over the course of 4 weeks through a telehealth provider, keeping note of the patients’ demographics, adverse events, and patient-reported dissociation for analysis.

Using the Patient Health Questionnaire (PHQ-9) for depression and the Generalized Anxiety Disorder scale (GAD-7) for anxiety, the researchers found that 62.8% of patients reported a 50% or greater improvement on the PHQ-9 (d = 1.61) and 62.9% on the GAD-7 (d = 1.56). Adverse effects of the treatment were reported by fewer than 5% of patients. Remission rates were 32.6% for PHQ-9 and 31.3% for GAD-7.

After the study’s completion, the researchers noted 3 patient subpopulation groups, categorized as: (1) improvement (79.3%); (2) chronic (11.4%), and (3) delayed improvement (9.3%). Over the course of the study, 4 patients left treatment early due to side effects or clinician disqualification, and 2 patients left due to adverse events.

With psychosocial support and remote monitoring through telehealth platforms, the researchers’ aim for the study was to break access barriers, such as the COVID-19 pandemic.

“The combination of strong and rapid effects with very small numbers of adverse events suggest that at-home sublingual ketamine therapy is an important avenue for overcoming long-standing barriers to depression and anxiety treatment, safely and conveniently,” the researchers concluded. “Evaluating the durability of these effects will be important for future research.”

 

—Jessica Ganga

Reference:

Hull TD, Malgaroli M, Gazzaley A, et al. At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression: findings from a large, prospective, open-label effectiveness trial. J. Affect. Disord. 2022;314:59-67. doi:10.1016/j.jad.2022.07.004

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