Ketamine treatment for depression: opportunities for clinical innovation and ethical foresight.
Ilina Singh, Celia J. A. Morgan, Valerie H. Curran, David Nutt, Anne K. Schlag, Rupert McShane
The Lancet Psychiatry April 5, 2017 DOI: 10.1016/s2215-0366(17)30102-5 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review and analysis Peer reviewed |
|---|---|
| Topics | Depression Esketamine Ketamine |
| Keywords | Ketamine treatment ketamine Powerful intervention Fast-acting antidepressant effects Depression treatment depression Severe depression Rapidly alleviate New treatment models New perspective Opportunities Beacon of hope Responsibly delivered Widely accessible Patient well-being |
| Citations | 158 |
| Key findings | Off-label ketamine use for severe, treatment-resistant depression does not violate ethical principles, provided guidelines for good practice are enacted, trial data are registered, and risks are monitored. |
Abstract
We present a review and analysis of the ethical considerations in off-label ketamine use for severe, treatment-resistant depression. The analysis of ethical considerations is contextualised in an overview of the evidence for ketamine use in depression, and a review of the drug's safety profile. We find that, based on current evidence, ketamine use for severe, treatment-resistant depression does not violate ethical principles; however, clinicians and professional bodies must take steps to ensure that guidelines for good practice are enacted, that all experimental and trial data are made available through national registries, and that the risk potential of ketamine treatment continues to be monitored and modelled. We conclude with a set of key recommendations for oversight bodies that would support safe, effective, and ethical use of ketamine in 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 59
- Attenuation of Antidepressant Effects of Ketamine by Opioid Receptor Antagonism American Journal of Psychiatry August 29, 2018
- Rapid‐acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective Psychiatry and Clinical Neurosciences June 19, 2019
- Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression. New England Journal of Medicine May 24, 2023
- Ketamine for suicidal ideation in adults with psychiatric disorders: A systematic review and meta-analysis of treatment trials Australian & New Zealand Journal of Psychiatry November 15, 2019
- Molecular and cellular mechanisms underlying the antidepressant effects of ketamine enantiomers and its metabolites Translational Psychiatry November 7, 2019
and 54 more in the library
Cites 17
- A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Archives of General Psychiatry August 1, 2006
- NMDAR inhibition-independent antidepressant actions of ketamine metabolites Nature April 24, 2016
- Ketamine use: a review Addiction July 21, 2011
- A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders JAMA Psychiatry March 1, 2017
- Ketamine for chronic pain: risks and benefits British Journal of Clinical Pharmacology February 21, 2013
and 12 more in the library