Ketamine/esketamine in the treatment of depression with comorbid borderline personality disorder or traits: A systematic review of effectiveness
Emma Scott, Don Thomas Thekkuden, Katelyn Kerr, Carla Meurk
Australian & New Zealand Journal of Psychiatry September 20, 2025 DOI: 10.1177/00048674251374472 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized Peer reviewed |
|---|---|
| Population | People with comorbid borderline personality disorder and depression |
| Interventions | ketamine esketamine |
| Topics | Depression Esketamine Ketamine |
| Keywords | Borderline personality disorder Suicidal ideation Depression economics Randomized controlled trial Systematic review Comorbidity Dissociative Clinical psychology Medline Poison control Clinical trial |
| Citations | 2 |
| Key findings | Ketamine or esketamine may improve depression symptoms in those with comorbid borderline personality disorder, but caution is warranted due to risks of suicidal ideation, self-harm, and acute dissociation. |
Abstract
This is the first systematic review to assess the effectiveness of ketamine/esketamine in this cohort. Our findings suggest that ketamine/esketamine may be useful in improving symptoms of depression, in those with comorbid borderline personality disorder. Limited study data are available; however, given case reports of suicidal ideation and self-harm following treatment cessation, as well as indications of a higher risk of acute dissociation in individuals with borderline personality disorder, clinicians should exercise caution when using ketamine to treat depression in this population. More data are required including a larger randomised control trial to assess the efficacy and side effects of ketamine/esketamine in this study population. Clinicians should, where available and appropriate, consider offering ketamine/esketamine to patients in this cohort.