{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:47:04Z","timestamp":1792640824634,"version":"4.5.0"},"reference-count":49,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2015,10,19]],"date-time":"2015-10-19T00:00:00Z","timestamp":1445212800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec id=\"S0033291715002159_sec_a1\"><jats:title>Background<\/jats:title><jats:p>While oral antidepressants reach efficacy after weeks, single-dose intravenous (i.v.) ketamine has rapid, yet time-limited antidepressant effects. We aimed to determine the efficacy and safety of single-dose i.v. ketamine augmentation of escitalopram in major depressive disorder (MDD).<\/jats:p><\/jats:sec><jats:sec id=\"S0033291715002159_sec_a2\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Thirty outpatients with severe MDD (17-item Hamilton Rating Scale for Depression total score \u2a7e24) were randomized to 4 weeks double-blind treatment with escitalopram 10 mg\/day+single-dose i.v. ketamine (0.5 mg\/kg over 40 min) or escitalopram 10 mg\/day + placebo (0.9% i.v. saline). Depressive symptoms were measured using the Montgomery\u2013Asberg Depression Rating Scale (MADRS) and the Quick Inventory of Depressive Symptomatology \u2013 Self-Report (QIDS-SR). Suicidal ideation was evaluated with the QIDS-SR item 12. Adverse psychopathological effects were measured with the Brief Psychiatric Rating Scale (BPRS)-positive symptoms, Young Mania Rating Scale (YMRS) and Clinician Administered Dissociative States Scale (CADSS). Patients were assessed at baseline, 1, 2, 4, 24 and 72 h and 7, 14, 21 and 28 days. Time to response (\u2a7e50% MADRS score reduction) was the primary outcome.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291715002159_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>By 4 weeks, more escitalopram + ketamine-treated than escitalopram + placebo-treated patients responded (92.3% <jats:italic>v.<\/jats:italic> 57.1%, <jats:italic>p<\/jats:italic> = 0.04) and remitted (76.9% <jats:italic>v.<\/jats:italic> 14.3%, <jats:italic>p<\/jats:italic> = 0.001), with significantly shorter time to response [hazard ratio (HR) 0.04, 95% confidence interval (CI) 0.01\u20130.22, <jats:italic>p<\/jats:italic> &lt; 0.001] and remission (HR 0.11, 95% CI 0.02\u20130.63, <jats:italic>p<\/jats:italic> = 0.01). Compared to escitalopram + placebo, escitalopram + ketamine was associated with significantly lower MADRS scores from 2 h to 2 weeks [(peak = 3 days\u20132 weeks; effect size (ES) = 1.08\u20131.18)], QIDS-SR scores from 2 h to 2 weeks (maximum ES = 1.27), and QIDS-SR suicidality from 2 to 72 h (maximum ES = 2.24). Only YMRS scores increased significantly with ketamine augmentation (1 and 2 h), without significant BPRS or CADSS elevation.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291715002159_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Single-dose i.v. ketamine augmentation of escitalopram was safe and effective in severe MDD, holding promise for speeding up early oral antidepressant efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291715002159","type":"journal-article","created":{"date-parts":[[2015,10,19]],"date-time":"2015-10-19T08:18:48Z","timestamp":1445242728000},"page":"623-635","source":"Crossref","is-referenced-by-count":125,"title":["Single i.v. ketamine augmentation of newly initiated escitalopram for major depression: results from a randomized, placebo-controlled 4-week study"],"prefix":"10.1017","volume":"46","author":[{"given":"Y.-D.","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.-T.","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.-X.","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Zu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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