A Systematic Review of Methodological Approaches in Indian Studies Evaluating Effectiveness of Ketamine Therapy for Psychiatric Disorders: Recommendations for Future Research
Swarndeep Singh, Saurabh Kumar, Shaily Mina, Manushree Gupta, Pankaj Verma
Annals of Indian Psychiatry August 22, 2025 DOI: 10.4103/aip.aip_186_25 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Double-blind Preregistered Peer reviewed |
|---|---|
| Sample size | 13 |
| Population | Indian studies assessing ketamine for psychiatric disorders |
| Topics | Ketamine Esketamine |
| Keywords | Systematic review Medline |
| Key findings | Indian studies on ketamine for psychiatric disorders show growing interest but suffer from significant methodological limitations, including small sample sizes, infrequent randomization, lack of double-blind designs, and inadequate safety monitoring. |
Abstract
Ketamine has emerged as a promising treatment strategy for several psychiatric disorders, with rising number of studies examining its safety and efficacy in Indian settings. However, concerns remain regarding their methodological robustness. To systematically review and evaluate the methodological quality of Indian studies assessing the use of ketamine for treating psychiatric disorders and provide recommendations for improving future research design. Review was conducted in accordance with the PRISMA 2020 guidelines and preregistered protocol on PROSPERO (CRD42025640071). PubMed, Google Scholar, and journals of national and zonal branches of the Indian Psychiatric Society journals were systematically searched to identify eligible studies published till December 2024 as per the predefined criteria. Details related to study methodology and ketamine administration were extracted and synthesized narratively. Thirteen studies were included. Most were single-centered prospective trials with small sample sizes (median: 25). Only five studies reported randomization, two involved blinding of outcome assessors, and none used double-blind design. Efficacy was assessed using standardized psychiatric scales; however, adverse effects were primarily evaluated using unstructured observation or self-report. Allocation concealment, flexible dosing, and systematic safety monitoring were infrequently reported. Although Indian studies demonstrate growing interest in exploring ketamine treatment for psychiatric disorders, especially depression, majority of them suffer from significant methodological limitations. Future research should prioritize adopting a rigorous study design including proper randomization, appropriate control group, blinding of participants, and outcome assessors, using structured tools for assessment of ketamine-related adverse events and adequate sample size to enhance reliability and generalizability of study findings.
Comparable studies
Other systematic reviews and meta-analyses on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis Depressed patients with suicidal ideation at baseline | 2017 | Systematic review and individual participant data meta-analysis | n = 167 |
| Ketamine use: a review Ketamine users | 2011 | Systematic review | |
| Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression Participants with major depression in placebo-controlled, double-blind, randomized... | 2015 | Systematic review and meta-analysis | |
| Ketamine and postoperative pain – a quantitative systematic review of randomised trials Surgical patients from 25 countries | 2004 | Systematic review | n = 2,839 |
| Side-effects associated with ketamine use in depression: a systematic review. Patients with depression | 2018 | Systematic review |
Citations in the library
Cites 4
- Efficacy of ketamine therapy in the treatment of depression Indian Journal of Psychiatry 2019
- A randomised, open-label, pragmatic pilot comparison of oral and intravenous ketamine in treatment-resistant depression. Asian Journal of Psychiatry September 1, 2024
- Retrospective data analysis to determine the effectiveness of intravenous ketamine therapy on patients suffering from depression with suicidal ideation Industrial Psychiatry Journal 2023
- A Novel, Brief, Fully Automated Intervention to Extend the Antidepressant Effect of a Single Ketamine Infusion: A Randomized Clinical Trial American Journal of Psychiatry September 21, 2022