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Master Thesis

Évaluer l’efficacité de l’association d’une injection de kétamine et de la venlafaxine dans l’épisode dépressif majeur sévère durant six semaines : « KETADEP »

Abstract : Antidepressant drugs have a lag of onset of action. Therefore, further strategies are needed to improve patient cares. Ketamine (N-methyl-D-aspartate antagonist) is an interesting emergent treatment for depression because improvement comes only after few hours and lasts above one week. Assumption: A single ketamine infusion (0.5 mg/kg IV) improves efficiency of venlafaxine treatment during six weeks. Patients: Forty patients suffer from severe unipolar major depressive disorder will be recruited. Method: It is a phase III, doubled blind, randomized, controlled, clinical trial. After one week drug free period, patients were given an intravenous infusion of either ketamine or placebo (Day 0). Venlafaxine was started for all at the same time (Day 0) until six weeks. Depression intensity was assessed by the Montgomery and Asberg rating scale during six weeks. Preliminary Results: Four patients were randomized to each group: ketamine and venlafaxine (KV); placebo and venlafaxine (PV). At the end of the follow-up period, 4 patients met remission criteria in KV group whereas only 2 patients met remission criteria in PV group. This difference is not significant (OR = INF [95% confidence interval 0.1979; ], p = 0.429). However, if these remission rates are confirmed (100% versus 50%), a significant difference would be highlighted from 20 patients (OR = INF [95% confidence interval 1.1954; ], p = 0.032). Discussion: These preliminary results are encouraging, although the small number of patients does not allow testing adequately assumption. In any case there is no evidence that this assumption is futile and therefore the protocol continues until 2015.
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https://dumas.ccsd.cnrs.fr/dumas-01435334
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Submitted on : Friday, January 13, 2017 - 6:09:23 PM
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  • HAL Id : dumas-01435334, version 1

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Pierre Courvoisier. Évaluer l’efficacité de l’association d’une injection de kétamine et de la venlafaxine dans l’épisode dépressif majeur sévère durant six semaines : « KETADEP ». Médecine humaine et pathologie. 2013. ⟨dumas-01435334⟩

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