Some therapeutic patients may require a maintenance schedule and regular booster doses in their therapy program to ensure the sustained benefits of treatment. This is particularly true for patients receiving ketamine therapy for treatment-resistant depression. The need for maintenance and booster doses can be attributed to the following reasons:
- Relapse prevention: The antidepressant effects of ketamine can be transient, lasting from a few days to several weeks (1). Regular booster doses can help maintain the therapeutic benefits and prevent symptom relapse in patients with treatment-resistant depression.
- Long-term efficacy: Studies have shown that repeated ketamine infusions can lead to a cumulative antidepressant effect, with increased response rates and longer-lasting benefits (2). A maintenance schedule can help ensure the long-term efficacy of ketamine therapy for patients.
- Individual variability: Patients may respond differently to ketamine therapy, with some experiencing more rapid symptom recurrence than others (3). A personalized maintenance schedule can be tailored to each patient’s needs based on their response to treatment and symptom severity.
- Synergy with psychotherapy: Regular ketamine booster doses can complement psychotherapy by maintaining a state of enhanced neuroplasticity, which facilitates therapeutic change and personal growth (4).
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Murrough, J. W., Perez, A. M., Pillemer, S., Stern, J., Parides, M. K., aan het Rot, M., … & Charney, D. S. (2013). Rapid and longer-term antidepressant effects of repeated ketamine infusions in treatment-resistant major depression. Biological psychiatry, 74(4), 250-256. https://www.sciencedirect.com/science/article/pii/S0006322312002759
Diamond, P. R., Farmery, A. D., Atkinson, S., Haldar, J., Williams, N., Cowen, P. J., … & McShane, R. (2014). Ketamine infusions for treatment-resistant depression: a series of 28 patients treated weekly or twice weekly in an ECT clinic. Journal of Psychopharmacology, 28(6), 536-544. https://journals.sagepub.com/doi/full/10.1177/0269881114527361
Abdallah, C. G., Sanacora, G., Duman, R. S., & Krystal, J. H. (2018). The neurobiology of depression, ketamine, and rapid-acting antidepressants: Is it glutamate inhibition or activation? Pharmacology & Therapeutics, 190, 148-158. https://www.sciencedirect.com/science/article/pii/S0163725818300255