The interactive effects of ketamine and magnesium upon depressive-like pathology

Magnesium in Ketamine Administration in Treatment-Resistant Depression

Relationship between depression and magnesium levels is reported. This observational study examined whether serum magnesium concentration change over time of ketamine treatment course, also whether association between magnesium concentrations and treatment response measured with Montgomery-Åsberg Depression Rating Scale (MADRS) score occurs. Moreover, interlink between changes in Young Mania Rating Scale (YMRS) score, somatic comorbidities, and magnesium concentration was studied. Inpatients with major depressive disorder or bipolar disorder were rated weekly by clinician using MADRS and YMRS. Magnesium levels assessments were carried out weekly, before start of ketamine treatment and then every second infusion and one week after last ketamine infusion. The concentration of Mg²⁺ ions differs depending on the measurement. The Mg²⁺ concentration in pre-measurement was significantly higher than in measurement after five infusions (p = 0.031) and after seven infusions (p = 0.003). No significant correlation was observed between changes in magnesium serum levels and MADRS or YMRS. The concentration of Mg²⁺ ion in course of the treatment was not associated with somatic comorbidities. The study supports data for role of magnesium in treatment-resistant depression, particularly related to ketamine treatment, but provides no clear evidence of straightforward association between magnesium serum concentration and treatment response or comorbidity.

The effects of magnesium supplementation on serum level of brain derived neurotrophic factor (BDNF) and depression status in patients with depression

OBJECTIVE

Recent researches suggest that there is a relationship between the pathogenesis of depression and serum Brain Derived Neurotrophic Factor (BDNF) levels. Therefore, the purpose of this clinical trial was to determine effect of magnesium supplementation on serum Level of BDNF, magnesium and depression status in patients with depression.

METHODS

A double blind randomized clinical trial was conducted on 46 depressed subjects. The participants were randomly allocated into the magnesium (MG) and the placebo (PG) group and received 500 mg magnesium and placebo daily for 8 weeks. Beck's test was conducted and blood samples were taken at baseline and after the intervention period for analysis of serum magnesium and BDNF.

RESULTS

No significant differences were observed in assessed variables between the two groups at the baseline. At the end of intervention, supplementation with magnesium oxide had a significant effect on Beck's test (P = 0.01) and serum magnesium (P = 0.001), but had no significant effect on BDNF levels (P = 0.507) between the two groups.

CONCLUSIONS

Daily intake of 500 mg magnesium oxide for at least 8 weeks improved Beck's test score and serum magnesium in depressed patients, but had no significant effect on BDNF levels between the two groups, Which Further research is recommended.

Analgesic efficacy of ketamine and magnesium after laparoscopic sleeve gastrectomy: A randomized, double-blind, placebo-controlled trial

Background Ketamine and magnesium are antagonists of the N-methyl-d-aspartate receptor, and are valuable adjuvants for multimodal analgesia and opioid sparing. Data are limited regarding the opioid sparing efficacy of the combined intraoperative application of these agents in laparoscopic bariatric surgery. The objective of this study was to compare the postoperative opioid sparing properties of a single intraoperative dose of ketamine versus a combination of single doses of ketamine and magnesium after laparoscopic gastric sleeve resection in bariatric patients. Methods One hundred and twenty- six patients were randomly assigned to receive single boluses of ketamine alone 0.5 mg kg^-1 IV (ketamine group); combined ketamine bolus of 0.5 mg kg^-1 IV and magnesium 2 g IV (ketamine and magnesium group); or placebo. Opioid consumption at 24 h (in morphine equivalents); pain at rest; postoperative nausea and vomiting impact score; sedation scores; and trends of transcutaneous carbon-di-oxide values were analysed. Results The median (inter-quartile range [range]) morphine consumption at 24 h were 32 (24-47 [4.8-91]) mg in the ketamine group, 37 (18-53 [1-144]) mg in the ketamine and magnesium group, and 26 (21-36 [5-89]) mg in the control group and were not significantly different between the groups. There were no differences for all other outcomes examined. Conclusion Combined single intraoperative bolus doses of ketamine and magnesium did not result in postoperative opioid sparing after laparoscopic gastric sleeve resection.