Original ContributionsVital Sign Changes During Intravenous Ketamine Infusions for Depression An Exploratory Study of Prognostic IndicationsKeith, Katherine M. MS1; Geller, Jamarie MD2; Froehlich, Alexis BS3; Arfken, Cynthia PhD1; Oxley, Megan MD4; Mischel, Nicholas MD, PhD1 Author Information From the 1Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit 2Department of Psychiatry, University of Michigan Health, Ann Arbor 3Wayne State University School of Medicine, Detroit 4Michigan Progressive Health, Royal Oak, MI. Received September 30, 2021; accepted after revision January 15, 2022. Address correspondence to: Katherine M. Keith, MS, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Dr, Ste 3B, Detroit, MI 48201 (e-mail: [email protected]). Institutional Review Board: Wayne State University. K.M.K., J.G., and N.M. conceptualized and designed the study. K.M.K. and A.F. acquired data and C.A. performed the statistical analysis of data. All authors discussed and interpreted results. All authors contributed to the final manuscript. Journal of Clinical Psychopharmacology: 5/6 2022 - Volume 42 - Issue 3 - p 254-259 doi: 10.1097/JCP.0000000000001542 Buy Metrics Abstract Purpose/Background Subanesthetic dosing of intravenous ketamine has shown to be an effective treatment for patients with major depressive disorder. It is unknown whether sympathetic response is related to treatment outcomes. The purpose of this study is to evaluate sympathetic response to ketamine infusions as it relates to treatment outcomes. Methods/Procedures This retrospective study examines an outpatient population diagnosed with major depressive disorder or bipolar depression treated with ketamine infusions. Patient characteristics, depressive symptoms measured with the Patient Health Questionnaire (PHQ-9), and vital signs were retrieved by chart review. Patients (n = 145) were categorized as responders (50% reduction in PHQ-9 or less than 10 on final PHQ-9) or nonresponders. Changes in vital signs were recorded during each infusion for the initiation series. Findings/Results Ketamine responders (51.7%) showed a significant greater increase in systolic blood pressure response during the first infusion when compared with nonresponders. There was no difference seen in diastolic pressure, heart rate, or rate pressure product. Changes in vital signs for subsequent infusions also did not approach significance. Implications/Conclusions Physiologic sensitivity to the effects of ketamine may predict treatment responsiveness. Blood pressure and heart rate did not always increase. Further work should examine possible influences on physiologic responses. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.