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.
Comparable studies
Other narrative reviews on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine: a paradigm shift for depression research and treatment | 2019 | Review | |
| Rapid‐acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective | 2019 | Review | |
| Ketamine: A tale of two enantiomers | 2020 | Review | |
| Molecular mechanisms underlying the antidepressant actions of arketamine: beyond the NMDA receptor | 2021 | Review |
Citations in the library
Cited by 17
- Number needed to treat (NNT) for ketamine and esketamine in adults with treatment-resistant depression: A systematic review and meta-analysis. Journal of Affective Disorders July 1, 2024
- Use of ketamine for treatment resistant depression: updated review of literature and practical applications to a community ketamine program in Edmonton, Alberta, Canada. Frontiers in Psychiatry 2023
- Anhedonia in bipolar depression treated with ketamine Bipolar Disorders February 4, 2024
- Effectiveness of repeated Esketamine nasal spray administration on anhedonic symptoms in treatment-resistant bipolar and unipolar depression: A secondary analysis from the REAL-ESK study group. Psychiatry Research July 26, 2025
- Royal Australian and New Zealand College of Psychiatrists professional practice guidelines for the use of ketamine in psychiatric practice. Australian & New Zealand Journal of Psychiatry April 28, 2025
and 12 more in the library
Cites 13
- A Randomized Add-on Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Bipolar Depression Archives of General Psychiatry August 1, 2010
- Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation American Journal of Psychiatry March 17, 2021
- Real-world effectiveness of ketamine in treatment-resistant depression: A systematic review & meta-analysis. Journal of Psychiatric Research May 1, 2022
- Ketamine for the acute treatment of severe suicidal ideation: double blind, randomised placebo controlled trial British medical journal February 2, 2022
- The acute antisuicidal effects of single-dose intravenous ketamine and intranasal esketamine in individuals with major depression and bipolar disorders: A systematic review and meta-analysis. Journal of Psychiatric Research December 11, 2020
and 8 more in the library