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The potential use of rapid-acting ketamine preparations for treatment-resistant major depression, which occurs in about 30% of patients, has sparked great interest. These researchers conducted a 4-week, industry-sponsored, phase 3, double-blind, multicenter trial enrolling 223 patients whose moderate-to-severe nonpsychotic major depression was nonresponsive to two adequately dosed antidepressants (62% women; 93% white; mean age, 46). Average illness duration was about 11 years, and current episodes lasted ≥2 years. Exclusions included recent suicidality, psychosis, bipolar disorder, major personality disorders, substance abuse, and uncontrolled hypertension.
The participants were switched to a new antidepressant (clinicians chose among 2 sel…