Date of Graduation

Fall 12-15-2017

Document Access

Project/Capstone - Global access

Degree Name

Master of Public Health (MPH)

College/School

School of Nursing and Health Professions

Abstract

Major depressive disorder is a psychiatric illness that is associated with a variety of debilitating symptoms such as persistent sadness, lack of interest and motivation, lassitude, pessimistic thoughts, and in severe cases, suicidal ideation and behavior. Current psychological and pharmacological treatments have been demonstrated efficacious; however, an ever-growing number of individuals frequently report minimal to no improvement with these treatments; and in some cases, a worsening of symptoms. This inadequacy to treatment is commonly known as treatment-resistant depression. At Kadima Neuropsychiatry Institute, Dr. Feifel treats individuals with treatment-resistant depression with advanced treatments such as TMS and ketamine. During my fieldwork internship at Kadima Neuropsychiatry Institute, my project focused on evaluating the efficacy of ketamine administered intramuscular to patients with treatment-resistant depression and determining which characteristics of a patient’s psychedelic experience or “trip” is associated with the decrease in their depressive symptoms. The results of this project demonstrated that an initial low dose of ketamine was significantly quick and efficacious in decreasing depressive symptoms in patients with treatment resistant depressive. In addition, a first of its kind exploratory analysis suggested that the intensity, positive content, and dissociative characteristics of a ketamine induced psychedelic trip were strongly associated with the decrease in depressive symptoms. Despite the significance in these results, more research needs to include a larger sample and explore the specific subjective characteristics within a psychedelic “trip” to further understand its association with a decrease in depressive symptoms. The quick and efficacious antidepressant effects of ketamine demonstrated in this project provide much potential for a program involving a mobile ketamine clinic to address severe depression and suicidality. Such therapeutic and intervention potentials can be explored further given an expansion of current policy limiting ketamine as a schedule III substance.

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