The Role of Ketamine in the Treatment of Bipolar Depression: A Scoping Review.
Muhammad Youshay Jawad, Saleha Qasim, Menglu Ni, Ziji Guo, Joshua D. Di Vincenzo, Giacomo d'Andrea, Aniqa Tabassum, Andrea Mckenzie, Sebastian Badulescu, Iria Grande, Roger S McIntyre
Brain Sciences June 4, 2023 DOI: 10.3390/brainsci13060909 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Scoping review Randomized Open-label Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | Ketamine Depression Esketamine |
| Keywords | Bipolar depression Bipolar disorder Mood disorders Psychedelics |
| Citations | 46 |
| Key findings | Ketamine appears tolerable and shows some effectiveness for depression and suicidality in bipolar depression, with minimal risk of manic switching, but evidence is weak and further research is needed. |
Abstract
Bipolar depression remains a clinical challenge with a quarter of patients failing to respond to initial conventional treatments. Although ketamine has been extensively studied in unipolar depression, its role in bipolar disorder remains inconclusive. The aim of our scoping review was to comprehensively synthesize the current clinical literature around ketamine use in bipolar depression. A total of 10 clinical studies (5 randomized controlled trials and 5 open label studies) were selected. The preliminary evidence, albeit weak, suggests that ketamine is a promising treatment and calls for further interest from the research community. Overall, ketamine treatment appeared to be tolerable with minimal risk for manic/hypomanic switching and showed some effectiveness across parameters of depression and suicidality. Moreover, ketamine is a potential treatment agent in patients with treatment-resistant bipolar depression with promising data extracted from extant controlled trials and real-world effectiveness studies. Future studies are needed to identify ketamine's role in acute and maintenance treatment phases of bipolar depression. Moreover, future researchers should study the recurrence prevention and anti-suicidal effects of ketamine in the treatment of bipolar depression.