In a phase 3 trial across seven mood disorders centers in Australia and New Zealand, subcutaneous racemic ketamine was tested against midazolam for treatment-resistant depression. With flexible dosing (0.5–0.9 mg/kg), ketamine led to a 19.6% remission rate compared to 2.0% for midazolam, a significant difference. Fixed dosing (0.5 mg/kg) showed no difference. Acute side effects, such as psychotomimetic effects and blood pressure increases, resolved within two hours. The subcutaneous route proved practical and feasible.
A systematic review of 119 print and online news articles from 2015 to 2020 found that media coverage of ketamine for psychiatric disorders was extremely positive (68.9% of articles). The rapid antidepressant effect was frequently emphasized (73.1% of articles), while longer-term safety and efficacy received little attention. Side-effects were reported in 80.7% of articles, mainly acute psychotomimetic effects and addiction risk, but rarely cardiovascular or bladder effects. Key opinion leaders, such as clinicians, often provided overly optimistic quotes that went beyond the existing evidence base. The authors conclude that information shaping patient expectations is being communicated through the media, and clinicians should address patients' beliefs directly.
Ketamine and its derivatives are increasingly used for treatment-resistant depression, but they can cause side effects during and between treatment sessions. The Ketamine Side Effect Tool (KSET) was designed to monitor these effects, but its length limited its use in clinics. Using retrospective data from three outpatient services, researchers calculated how often side effects occurred within sessions, between sessions, and at follow-up. They then developed a shorter version, the KSET-Revised (KSET-R), which showed good construct and concurrent validity for specific items and an overall tolerability rating. The revised tool is more feasible for clinical practice and is recommended for monitoring side effects in patients receiving ketamine treatment.