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Efficacy of Oral Ketamine in Patients with Depression and Suicidality: A Retrospective Study.

Zaid Ahmad Wani, Rajnish Raj, Shabir Ahmad Dar, Inaamul Haq

Indian Journal of Psychological Medicine January 22, 2026 DOI: 10.1177/02537176251415001 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Retrospective cross-sectional study Peer reviewed
Sample size 41
Population Patients diagnosed with major depressive disorder, bipolar depression, or suicidal ideation at a tertiary care psychiatric institute in India
Intervention Oral ketamine therapy
Duration After the third ketamine session
Topics Depression Esketamine Ketamine
Keywords Oral ketamine Rapid-acting antidepressant Sociocultural factors Suicidality
Key findings Oral ketamine therapy was associated with significant reductions in depressive symptoms and suicidal ideation after three sessions.

Abstract

Depression is a significant global health issue, often accompanied by suicidality, which requires urgent and effective interventions. Oral ketamine is emerging as a potential rapid-acting treatment, but data on its efficacy and tolerability remain limited, particularly in the Indian context. Thus, this retrospective study was conducted to assess the response to oral ketamine in patients with depression and suicidality. A retrospective cross-sectional study was conducted on 41 patients diagnosed with major depressive disorder (MDD), bipolar depression (bipolar affective disorder [BPAD] depression), or who had suicidal ideation, all of whom were administered oral ketamine therapy at a tertiary care psychiatric institute in India. Depression severity and suicidal ideation were assessed using the Hamilton Depression Rating Scale (HAMD) and the Modified Scale for Suicidal Ideation (MSSI), respectively, at baseline and after the third ketamine session. Sociodemographic and clinical variables were analyzed to explore their association with treatment outcomes. The mean reduction in HAMD and MSSI scores post-third ketamine session was 8.19 (p < .001) and 4.95 (p < .001), respectively, indicating significant improvements in both depressive symptoms and suicidal ideation. Common side effects included dizziness, nausea, and hypertension, and the least common was diarrhea. Oral ketamine appears to be an effective and well-tolerated option for rapidly reducing depressive symptoms and suicidal ideation in patients with MDD and BPAD depression. It can be used in outpatient settings to provide immediate benefit to patients. Future studies with robust, prospective designs are needed to determine optimal dosing, evaluate long-term safety, and establish sustained efficacy.

Comparable studies

Other cross-sectional and survey studies on ketamine for depression, most cited first.

Study Year Design Participants
Parental Attitudes Toward Use of Ketamine in Adolescent Mood Disorders and Suicidality English-speaking parents of adolescents 2021 Cross-sectional survey n = 283
A Real-World Study on the Use, Effectiveness, and Safety of Esketamine Nasal Spray in Patients with Treatment-Resistant Depression: INTEGRATE Study. Adults aged 18-74 years with treatment-resistant depression in Spain 2025 Observational, cross-sectional, retrospective study n = 196
Self-Reported Improvements in Comorbid Post-Traumatic Stress Disorder Symptoms, Depression, Anxiety, and Sleep Among Real-World Patients Receiving Medical Ketamine: Exploring the Role of Adjunct Therapies. Real-world patients with PTSD (n=98) and without PTSD (n=104) who received ketamine... 2025 Secondary analysis of survey data n = 202
Attitudes and Perceptions of Portuguese Psychiatrists and Psychologists on the Clinical Use of Ketamine. Portuguese psychiatrists and psychologists 2025 Cross-sectional survey n = 156
Efficacy of Electroconvulsive Therapy and Ketamine Therapy in Major Depressive Disorder; A Comparative Study Hospitalized patients with major depressive disorder 2023 Comparative cross-sectional study n = 40

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