Citation

Danayan K, Chisamore N, Rodrigues NB, Vincenzo JDD, Meshkat S, Doyle Z, Mansur R, Phan L, Fancy F, Chau E, Tabassum A, Kratiuk K, Arekapudi A, Teopiz KM, McIntyre RS, Rosenblat JD. Psychiatry Res. 2023; 323: e115133.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.psychres.2023.115133

PMID

36889160

Abstract

Borderline personality disorder (BPD) has high rates of comorbidity with mood disorders, including treatment-resistant depression (TRD). Comorbidity of BPD with depression is associated with poorer response to antidepressants. Intravenous ketamine is a novel treatment for TRD that has not been specifically evaluated in patients with comorbid BPD. In this retrospective analysis of data collected from participants who received care at the Canadian Rapid Treatment Centre of Excellence (CRTCE; Braxia Health; ClinicalTrials.gov: NCT04209296), we evaluated the effectiveness of intravenous ketamine in a TRD population with comorbid BPD (N=100; n=50 BPD-positive compared with n=50 BPD-negative). Participants were administered four doses of intravenous ketamine (0.5-0.75mg/kg over 40 minutes) over two weeks. The primary outcome measures were changes in depressive symptom severity (as measured by Quick Inventory of Depressive Symptomatology-Self Report 16-item (QIDS-SR(16))) and borderline symptom severity (as measured by Borderline Symptom List 23-item (BSL-23)). Both BPD-positive and BPD-negative groups improved significantly on the QIDS-SR(16), QIDS-SR(16) suicide ideation item, anxiety, and functionality scales with large effect sizes. There was no significant difference between groups. The BPD-positive group exhibited significant reduction of 0.64 on BSL-23 scores and a significant reduction of 5.95 on QIDS-SR(16) scores. Patients with TRD and comorbid BPD receiving ketamine exhibited a significant reduction in symptoms of depression, borderline personality, suicidality, and anxiety.

Language: en

Keywords

*Borderline Personality Disorder/complications/drug therapy/epidemiology; *Depressive Disorder, Treatment-Resistant/complications/drug therapy/epidemiology; *Ketamine/pharmacology/therapeutic use; Bipolar disorder; Borderline personality disorder; Canada/epidemiology; Cluster B Traits; Comorbidity; Depression/epidemiology; Emotionally unstable personality disorder; Esketamine; Humans; Ketamine; Major depressive disorder; Retrospective Studies; Treatment resistant depression