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Anhedonia, a prominent symptom of depressive syndromes, occurs in most patients with bipolar depression and has been associated with poorer treatment outcomes. Little treatment research has targeted the symptom. Using a randomized, double-blind, crossover study design, investigators examined effects of a single infusion of ketamine or placebo in 36 patients with treatment-resistant bipolar I or II disorder. One author has patent interests in the clinical use of ketamine.
All patients were experiencing a major depressive episode, and 31 had clinically significant anhedonia. All patients were taking lithium or valproate but had no other medications or psychotherapy. Ketamine significantly reduced anhedonia quickly and over the subsequent 14 da…