EPV580 - Clinical Outcomes of Ketamine Therapy for Depression, Anxiety, and PTSD in Post-TBI Patients

EPV580

Clinical Outcomes of Ketamine Therapy for Depression, Anxiety, and PTSD in Post-TBI Patients

W. Aldulaimy¹, A. Shah^2,*

¹Psychiatry, ²Texas Institute for Graduate Medical Education and Research , San Antonio, United States

Introduction: TBI patients often suffer from severe, treatment-resistant depression and PTSD. Ketamine shows promise in non-TBI populations, but its efficacy in TBI patients needs exploration for efficacy and tolerability.

Objectives: Evaluate ketamine's clinical effectiveness and safety (PHQ-9, GAD-7, PCL-5 scores) in post-TBI patients, comparing IM, intranasal, and oral routes.

Methods: Design: Retrospective chart review of 35 adult TBI patients (mean age 38.4; TBI 3.5 years prior).

Formulations: IM (0.5-0.75 mg/kg), Intranasal (84 mg esketamine), and Oral Dissolving Tablets (100-300 mg).

Measures: PHQ-9, GAD-7, and PCL-5 scores.
Analysis: Efficacy by % reduction, response (≥50% reduction), and remission (PHQ-9 < 5, PCL-5 < 20).

Results: Magnitude: Large effect sizes

observed (32.7% GAD-7/ODT to 65.6%

PCL-5/Nasal).
Clinical: 72% response, 45% remission

rates.
Route-Dependent: Parenteral

(IM/Nasal) outperformed ODT due to better bioavailability.

Rapid Onset: Initial improvement within 5-10 days.

Safety: Favorable profile with mild, transient adverse events.

Conclusions: Magnitude: Large effect sizes