Letter to the Editor
Ketamine associated with electroconvulsive therapy for treatment-resistant depression in the elderly: Two case reports
Ketamina asociada a terapia electroconvulsiva en depresión resistente al tratamiento en pacientes de edad avanzada: a propósito de 2 casos
Adriana Forteaa,
, Laura Espinosaa, Clara Oliverasa, Pol Brugueraa, Antoni Benabarrea,b,c,d
Corresponding author
a Servicio de Psiquiatría y Psicología, Instituto Clínico de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
b Servicio de Psiquiatría y Psicología, Programa de Trastornos Bipolares, Instituto Clínico de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
c Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
d Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain
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"apellidos" => "Fortea" "email" => array:1 [ 0 => "fortea@clinic.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Laura" "apellidos" => "Espinosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Clara" "apellidos" => "Oliveras" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Pol" "apellidos" => "Bruguera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Antoni" "apellidos" => "Benabarre" "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => 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"aff0015" ] 3 => array:3 [ "entidad" => "Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ketamina asociada a terapia electroconvulsiva en depresión resistente al tratamiento en pacientes de edad avanzada: a propósito de 2 casos" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Treatment-resistant depression (TRD) is a common disease. It is calculated that from 60% to 70% of patients will respond to a first-line monotherapy, and that more than one third will be therapy-resistant,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> considering those patients who fail to respond to 2 different antidepressives at suitable doses and for a suitable duration to be resistant.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Electroconvulsive therapy (ECT) has been shown to be highly effective in as a therapy for TRD as well as safe, even in geriatric patients.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> In spite of this, this, a significant number of subjects do not respond to ECT with conventional anaesthetics. We present 2 cases of TRD treated using ECT associated with ketamine.</p><p id="par0010" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Case 1:</span> an 80 year-old male with a history of colon and lung adenocarcinoma, currently disease-free, with no history of psychiatric problems or known cognitive deterioration, who was admitted due to a severe depressive episode with psychotic symptoms (DSM-5 296.24 [F32.3]) evolving over 4 months without responding to 20<span class="elsevierStyleHsp" style=""></span>mg/day Citalopram and 25<span class="elsevierStyleHsp" style=""></span>mg/day Quetiapine; Hamilton Depression Rating Scale of 17 items<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> (HDRS-17)<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23. Treatment was gradually commenced with 225<span class="elsevierStyleHsp" style=""></span>mg/day Venlafaxine, 45<span class="elsevierStyleHsp" style=""></span>mg/day Mirtazapine, 5<span class="elsevierStyleHsp" style=""></span>mg/day Olanzapine and 100<span class="elsevierStyleHsp" style=""></span>mg/day Nortriptyline, without improvement. To manage anxiety 192<span class="elsevierStyleHsp" style=""></span>mg Clometiazol was used to varying degrees throughout treatment. Concomitantly, 12 sessions of basic bitemporal ECT were applied (3 sessions/week) (pulse amplitude 1.0<span class="elsevierStyleHsp" style=""></span>ms and 36<span class="elsevierStyleHsp" style=""></span>J energy increasing to 88.3<span class="elsevierStyleHsp" style=""></span>J using changes in frequency and stimulus duration), with 175<span class="elsevierStyleHsp" style=""></span>mg pentothal as anaesthetic. A suboptimum electrocephalographic average convulsion time was detected (avct) (16.58<span class="elsevierStyleHsp" style=""></span>s/session) and short periods of confusion and disorientation were observed post-administration. Given the persistence of depressive symptoms (HDRS-17<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>18) palliative treatment was initiated using 6 sessions of endovenous ketamine on alternate days (0.63<span class="elsevierStyleHsp" style=""></span>mg/kg) with a notable improvement in symptoms (HDRS-17<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>5 following 2 sessions) which was no sustained over time (HDRS-17<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>19, 15 days after the end of the treatment).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Finally, after withdrawing Nortriptyline due to lack of effectiveness, 9 bilateral basic ECT sessions with ketamine as the anaesthetic were tried (0.9–1.34<span class="elsevierStyleHsp" style=""></span>mg/kg), achieving a suitable avct (28.36<span class="elsevierStyleHsp" style=""></span>s/session) while it was possible to reduce the energy to 75<span class="elsevierStyleHsp" style=""></span>J, keeping an amplitude of 1.0<span class="elsevierStyleHsp" style=""></span>ms, with good tolerability. The patient suffered the complication of a septic shock secondary to infection of the central catheter that made it necessary to suspend the ECT during 12 days. It was restarted with 8 sessions more per week of ECT-ketamine, showing a clear improvement in symptoms (HDRS-17<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2). The patient is currently in remission 14 months after discharge, with maintenance ECT-ketamine (monthly) and 75<span class="elsevierStyleHsp" style=""></span>mg/day Venlafaxine and 30<span class="elsevierStyleHsp" style=""></span>mg/day Mirtazapine.</p><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Case 2:</span> a 69 year-old male without a medical-surgical or psychiatric record or known cognitive deterioration (mini mental state examination<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>27) who was admitted due to an episode of severe depression with psychotic symptoms (DSM-5 296.24 [F32.3]) that had evolved over 8 months. It had hardly responded to previous treatments with 100<span class="elsevierStyleHsp" style=""></span>mg/day Sertraline, 30<span class="elsevierStyleHsp" style=""></span>mg/day Citalopram and 225<span class="elsevierStyleHsp" style=""></span>mg/day Venlafaxine combined with low doses of antipsychotic drugs. During admission 175<span class="elsevierStyleHsp" style=""></span>mg/day Imipramine was tried, together with 30<span class="elsevierStyleHsp" style=""></span>mg/day Mirtazapine and 15 sessions of basic bitemporal ECT (amplitude 1.0<span class="elsevierStyleHsp" style=""></span>ms; energy 43<span class="elsevierStyleHsp" style=""></span>J), with 200<span class="elsevierStyleHsp" style=""></span>mg pentothal and avct<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>23<span class="elsevierStyleHsp" style=""></span>s/session, with episodes of disorientation and loss of short-term memory post-administration. Given the lack of response 11 basic sessions were applied of ECT-ketamine at 1.4<span class="elsevierStyleHsp" style=""></span>mg/kg (energy 38<span class="elsevierStyleHsp" style=""></span>J; avct<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>50.9<span class="elsevierStyleHsp" style=""></span>s/session) with an improvement in symptoms (HDRS<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8) and no side effects.</p><p id="par0025" class="elsevierStylePara elsevierViewall">At discharge he presented a new recurrence of the disorder (HDRS-36) following the switch from Imipramine to Venlafaxine due to a lack of supply, and after finalising the ECT-ketamine sessions. It was then decided to use treatment with 112.5<span class="elsevierStyleHsp" style=""></span>mg/day Clomipramine, 100<span class="elsevierStyleHsp" style=""></span>mg/day Sertraline and the commencement of 800<span class="elsevierStyleHsp" style=""></span>mg/day lithium without response, so that Imipramine was restarted at 100<span class="elsevierStyleHsp" style=""></span>mg/day and 17 basic sessions of ECT-ketamine at 1.28<span class="elsevierStyleHsp" style=""></span>mg/kg were administered (energy 31<span class="elsevierStyleHsp" style=""></span>J; avct<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>44.3 Imipramine/session) with a clinical improvement (HDRS<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>12) and good tolerability. One month after discharge he was clinically stable without complete remission, in treatment with 75<span class="elsevierStyleHsp" style=""></span>mg/day Imipramine, 150<span class="elsevierStyleHsp" style=""></span>mg/day Quetiapine and 15<span class="elsevierStyleHsp" style=""></span>mg/day Mirtazapine, while the outpatient department decided against maintaining ECT-ketamine.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Ketamine is an anaesthetic that is an antagonist of N-methyl-<span class="elsevierStyleSmallCaps">d</span>-aspartate (NMDA) receptors; it is involved in the glutamatergic route and is of growing interest in the physiopathology of depression.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Treatment with ketamine has been shown to have a swift antidepressive response, although its use is controversial and data on this in the literature are contradictary.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6–8</span></a> A study conducted with 90 subjects with TRD showed faster and more sustained improvement in depressive symptoms, increasing cognitive protection and the duration of convulsion in those patients treated with anaesthetic doses of ketamine (0.8<span class="elsevierStyleHsp" style=""></span>mg/kg) and ECT.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Nevertheless, there is a notable lack of evidence on its safety and efficacy in elderly patients, who are a group especially susceptible to TRD.</p><p id="par0035" class="elsevierStylePara elsevierViewall">We believe that in our progress towards an increasingly personalised and technical psychiatry,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> ketamine may be a valid alternative to the use of conventional anaesthetics, giving a longer avct, which could play an important role in improving observed antidepressive efficacy. These results, together with the reported cognitive protection<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>—which was not evaluated in our subjects—mean that it is a desirable option for elderly patients, although more evidence is required to evaluate its effectiveness and safety in this age group.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Fortea A, Espinosa L, Oliveras C, Bruguera P, Benabarre A. Ketamina asociada a terapia electroconvulsiva en depresión resistente al tratamiento en pacientes de edad avanzada: a propósito de 2 casos. Rev Psiquiatr Salud Ment (Barc). 2017;10:125–126</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment-resistant depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Souery" 1 => "G.I. Papakostas" 2 => "M.H. Trivedi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Psychiatry" "fecha" => "2006" "volumen" => "67" "paginaInicial" => "16" "paginaFinal" => "22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16848672" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment-resistant depression: recent developments and future directions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.J. Mathew" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/da.20540" "Revista" => array:6 [ "tituloSerie" => "Depress Anxiety" "fecha" => "2008" "volumen" => "25" "paginaInicial" => "989" "paginaFinal" => "992" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19058261" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electroconvulsive therapy in the elderly: new findings in geriatric depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.T. Gedulding" 1 => "C.H. Kellner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11920-016-0674-5" "Revista" => array:5 [ "tituloSerie" => "Curr Psychiatry Rep" "fecha" => "2016" "volumen" => "18" "paginaInicial" => "40" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26909702" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rating scale for depression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Hamilton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry" "fecha" => "1960" "volumen" => "23" "paginaInicial" => "56" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14399272" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "¿Antidepresivos glutamatérgicos? Las sorprendentes propiedades antidepresivas de la quetamina" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F. Artigas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rpsm.2011.07.002" "Revista" => array:6 [ "tituloSerie" => "Rev Psiquiatr Salud Ment" "fecha" => "2011" "volumen" => "4" "paginaInicial" => "183" "paginaFinal" => "186" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23446263" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ketamine as the prototype glutamatergic antidepressant: pharmacodynamic actions, and a systematic review and meta-analysis of efficacy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Caddy" 1 => "G. Giaroli" 2 => "T.P. White" 3 => "S.S. Shergill" 4 => "D.K. Tracy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/2045125313507739" "Revista" => array:6 [ "tituloSerie" => "Ther Adv Psychopharmacol" "fecha" => "2014" "volumen" => "4" "paginaInicial" => "75" "paginaFinal" => "99" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24688759" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ketamine administration in depressive disorders: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Fond" 1 => "A. Loundou" 2 => "C. Rabu" 3 => "A. Macgregor" 4 => "C. Lançon" 5 => "M. Brittner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Psychopharmacology (Berlin)" "fecha" => "2014" "volumen" => "231" "paginaInicial" => "3663" "paginaFinal" => "3676" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic review and meta-analysis of randomized controlled trials of adjunctive ketamine in electroconvulsive therapy: efficacy and tolerability" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. McGirr" 1 => "M.T. Berlim" 2 => "D.J. Bond" 3 => "N.H. Neufeld" 4 => "P.Y. Chan" 5 => "L.N. Yatham" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpsychires.2015.01.003" "Revista" => array:6 [ "tituloSerie" => "J Psychiatr Res" "fecha" => "2015" "volumen" => "62" "paginaInicial" => "23" "paginaFinal" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25684151" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mood and neuropsychological effects of different doses of ketamine in electroconvulsive therapy for treatment-resistant depression" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X. Zhong" 1 => "H. He" 2 => "C. Zhang" 3 => "Z. Wang" 4 => "M. Jiang" 5 => "Q. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jad.2016.05.011" "Revista" => array:6 [ "tituloSerie" => "J Affect Disord" "fecha" => "2016" "volumen" => "201" "paginaInicial" => "124" "paginaFinal" => "130" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27208499" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La medicina personalizada aplicada a la salud mental: la psiquiatría de precisión" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Vieta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Psiquitr Salud Ment (Barc)" "fecha" => "2015" "volumen" => "8" "paginaInicial" => "117" "paginaFinal" => "118" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735050/0000001000000002/v1_201706080019/S2173505017300298/v1_201706080019/en/main.assets" "Apartado" => array:4 [ "identificador" => "7636" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735050/0000001000000002/v1_201706080019/S2173505017300298/v1_201706080019/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173505017300298?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 6 | 2 | 8 |
| 2024 September | 13 | 3 | 16 |
| 2024 August | 19 | 5 | 24 |
| 2024 July | 14 | 4 | 18 |
| 2024 June | 12 | 4 | 16 |
| 2024 May | 12 | 6 | 18 |
| 2024 April | 18 | 5 | 23 |
| 2024 March | 30 | 5 | 35 |
| 2024 February | 18 | 2 | 20 |
| 2024 January | 18 | 1 | 19 |
| 2023 December | 19 | 9 | 28 |
| 2023 November | 27 | 3 | 30 |
| 2023 October | 25 | 4 | 29 |
| 2023 September | 25 | 3 | 28 |
| 2023 August | 13 | 8 | 21 |
| 2023 July | 13 | 4 | 17 |
| 2023 June | 24 | 2 | 26 |
| 2023 May | 40 | 3 | 43 |
| 2023 April | 29 | 0 | 29 |
| 2023 March | 15 | 3 | 18 |
| 2023 February | 27 | 11 | 38 |
| 2023 January | 8 | 4 | 12 |
| 2022 December | 25 | 4 | 29 |
| 2022 November | 35 | 9 | 44 |
| 2022 October | 19 | 9 | 28 |
| 2022 September | 14 | 11 | 25 |
| 2022 August | 23 | 5 | 28 |
| 2022 July | 8 | 10 | 18 |
| 2022 June | 14 | 7 | 21 |
| 2022 May | 16 | 7 | 23 |
| 2022 April | 11 | 14 | 25 |
| 2022 March | 12 | 4 | 16 |
| 2022 February | 19 | 3 | 22 |
| 2022 January | 46 | 6 | 52 |
| 2021 December | 46 | 12 | 58 |
| 2021 November | 22 | 7 | 29 |
| 2021 October | 27 | 14 | 41 |
| 2021 September | 32 | 15 | 47 |
| 2021 August | 21 | 12 | 33 |
| 2021 July | 12 | 10 | 22 |
| 2021 June | 18 | 7 | 25 |
| 2021 May | 26 | 8 | 34 |
| 2021 April | 96 | 15 | 111 |
| 2021 March | 49 | 23 | 72 |
| 2021 February | 46 | 19 | 65 |
| 2021 January | 40 | 15 | 55 |
| 2020 December | 42 | 12 | 54 |
| 2020 November | 45 | 15 | 60 |
| 2020 October | 21 | 6 | 27 |
| 2020 September | 27 | 14 | 41 |
| 2020 August | 32 | 11 | 43 |
| 2020 July | 31 | 13 | 44 |
| 2020 June | 19 | 12 | 31 |
| 2020 May | 41 | 18 | 59 |
| 2020 April | 17 | 7 | 24 |
| 2020 March | 27 | 8 | 35 |
| 2020 February | 23 | 10 | 33 |
| 2020 January | 35 | 5 | 40 |
| 2019 December | 34 | 12 | 46 |
| 2019 November | 29 | 5 | 34 |
| 2019 October | 31 | 6 | 37 |
| 2019 September | 19 | 5 | 24 |
| 2019 August | 15 | 10 | 25 |
| 2019 July | 20 | 8 | 28 |
| 2019 June | 33 | 42 | 75 |
| 2019 May | 78 | 42 | 120 |
| 2019 April | 37 | 4 | 41 |
| 2019 March | 4 | 2 | 6 |
| 2019 February | 9 | 1 | 10 |
| 2019 January | 4 | 7 | 11 |
| 2018 December | 6 | 0 | 6 |
| 2018 November | 19 | 7 | 26 |
| 2018 October | 7 | 8 | 15 |
| 2018 September | 26 | 7 | 33 |
| 2018 August | 10 | 1 | 11 |
| 2018 July | 18 | 1 | 19 |
| 2018 June | 9 | 3 | 12 |
| 2018 May | 37 | 3 | 40 |
| 2018 April | 37 | 6 | 43 |
| 2018 March | 13 | 1 | 14 |
| 2018 February | 3 | 0 | 3 |
| 2018 January | 13 | 1 | 14 |
| 2017 December | 16 | 1 | 17 |
| 2017 November | 15 | 4 | 19 |
| 2017 October | 4 | 1 | 5 |
| 2017 September | 1 | 0 | 1 |
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