Most people with major depressive disorder do not achieve symptom remission, and treatment-resistant depression is defined by the failure of at least one adequate antidepressant trial. This study investigated clinical predictors of depressive symptom remission and response 24 hours and 7 days after infusions of racemic ketamine and esketamine.
Ketamine shows potential for fast onset of action and good tolerability in treating obsessive-compulsive disorder (OCD), but results have been erratic. The systematic review included nine articles: three randomized controlled trials, three case reports, two open-label trials, and one retrospective chart review. Most studies used only single-session racemic ketamine administered intravenously. No evidence demonstrates whether racemic ketamine, S-ketamine, or R-ketamine has the best efficacy, and only sparse evidence suggests combining ketamine with psychotherapy could benefit patients. Future randomized, double-blind, placebo-controlled trials with larger samples, multiple sessions, and appropriate washout periods are needed.