Propofol for Treatment-Resistant Depression: A Pilot Study

摘要: Background We hypothesized that propofol, a unique general anesthetic engages N-methyl-D-aspartate and gamma-aminobutyric acid receptors, has antidepressant properties. This open-label trial was designed to collect preliminary data regarding the feasibility, tolerability, efficacy of deep propofol anesthesia for treatment-resistant depression. Methods Ten participants with moderate-to-severe medication-resistant depression (age 18-45 years otherwise healthy) each received series 10 infusions. Propofol dosed strongly suppress electroencephalographic activity 15 minutes. The primary outcome 24-item Hamilton Depression Rating Scale. Self-rated scores were compared group 20 patients who electroconvulsive therapy. Results treatments well tolerated by all subjects. No serious adverse events occurred. Montreal Cognitive Assessment remained stable. decreased mean points (range 0-45 points), corresponding 58% improvement from baseline 0-100%). Six subjects met criteria response (>50% improvement). improved similarly in therapy group. Five 6 responders at least 3 months. In posthoc analyses, measures predicted clinical propofol. Conclusions These findings demonstrate high-dose treatment is feasible individuals are healthy. may trigger rapid, durable effects similar but fewer side effects. Controlled studies warranted further evaluate propofol's mechanisms action. ClinicalTrials.gov: NCT02935647.