Do baseline anxiety symptoms impact response to IV Ketamine in treatment resistant depression?

•We examined if anxious depression impacts Ketamine outcomes.•Forty-three patients received six IV Ketamine infusions over a three-week period.•Patients with anxious depression at baseline had comparable levels of improvement.•Improvement in anxiety was about half the magnitude of improvement in depression.•Depressed patients who present with anxiety may be appropriate for IV Ketamine. In a retrospective study, we analyzed if anxious depression impacts outcomes in patients with treatment resistant depression (TRD) receiving IV Ketamine infusions at an academic center Ketamine clinic. Forty-three patients with TRD received six IV Ketamine infusions over a three-week period. Anxious depression (ANX-TRD) was defined as a Hamilton Depression Rating Scale Anxiety/Somatization factor score of ≥ 7 at the baseline evaluation. Beck Depression Inventory (BDI-II) and Generalized Anxiety Disorder-7 (GAD-7) scales were used through the infusion course to assess symptom change. Twenty-three patients were categorized as ANX-TRD and 20 as non-anxious TRD. Generalized estimating equation (GEE) models revealed BDI-II and GAD-7 scores for ANX-TRD and NANX-TRD groups did not differ significantly during any time point. Symptoms of anxiety and depression improved after treatment in both groups, though the degree of change was significant and greater for depression. This was a naturalistic, retrospective study, without a control group. Symptoms of depression show greater improvement than symptoms of anxiety. IV Ketamine is effective in the treatment of depression, regardless of the baseline anxiety level.