A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders
Gerard Sanacora, Mark A Frye, William M. Mcdonald, Sanjay J. Mathew, Mason S. Turner, Alan F. Schatzberg, Paul Summergrad, Charles B. Nemeroff
JAMA Psychiatry March 1, 2017 DOI: 10.1001/jamapsychiatry.2017.0080 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review and consensus statement Peer reviewed |
|---|---|
| Topics | Anxiety Ketamine Esketamine |
| Keywords | Mood disorders Medline Clinical psychology Electroconvulsive therapy studies |
| Citations | 577 |
| Key findings | Ketamine can produce rapid and robust antidepressant effects in treatment-resistant mood and anxiety disorders, but the available data have significant limitations. |
Abstract
Importance: Several studies now provide evidence of ketamine hydrochloride's ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment. Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders. OBSERVATIONS: This review and consensus statement provides a general overview of the data on the use of ketamine for the treatment of mood disorders and highlights the limitations of the existing knowledge. While ketamine may be beneficial to some patients with mood disorders, it is important to consider the limitations of the available data and the potential risk associated with the drug when considering the treatment option.
Conclusions: AND RELEVANCE: The suggestions provided are intended to facilitate clinical decision making and encourage an evidence-based approach to using ketamine in the treatment of psychiatric disorders considering the limited information that is currently available. This article provides information on potentially important issues related to the off-label treatment approach that should be considered to help ensure patient safety.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Ketamine can produce rapid and robust antidepressant effects in treatment-resistant mood and anxiety disorders, but the authors emphasize small samples, limited long-term efficacy and safety data, and off-label risk.
Synthesized
Comparable studies
Other narrative reviews on ketamine for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| KETAMINE'S MECHANISM OF ACTION: A PATH TO RAPID‐ACTING ANTIDEPRESSANTS | 2016 | Review | |
| Eradicating Suicide at Its Roots: Preclinical Bases and Clinical Evidence of the Efficacy of Ketamine in the Treatment of Suicidal Behaviors | 2018 | Review | |
| Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder Patients with treatment-resistant depressive symptoms as part of major depressive... | 2018 | Narrative review | |
| Ketamine as a Fast Acting Antidepressant: Current Knowledge and Open Questions | 2013 | Review | |
| A New Perspective on the Anti-Suicide Effects With Ketamine Treatment Adults with treatment-resistant mood disorders | 2015 | Review |
Citations in the library
Cited by 247
- 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
- The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis American Journal of Psychiatry October 3, 2017
- Global Street Food: la cocina de la calle Diseño interior 2009
- Ketamine for rapid reduction of suicidal thoughts in major depression: a midazolam-controlled randomized clinical trial American Journal of Psychiatry December 5, 2017
- Single, Repeated, and Maintenance Ketamine Infusions for Treatment-Resistant Depression: A Randomized Controlled Trial. American Journal of Psychiatry March 29, 2019
and 242 more in the library
Cites 12
- Subanesthetic Effects of the Noncompetitive NMDA Antagonist, Ketamine, in Humans Archives of General Psychiatry March 1, 1994
- Ketamine use: a review Addiction July 21, 2011
- Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression American Journal of Psychiatry October 1, 2015
- A Double-Blind, Randomized, Placebo-Controlled, Dose-Frequency Study of Intravenous Ketamine in Patients With Treatment-Resistant Depression American Journal of Psychiatry April 8, 2016
- Intravenous Esketamine in Adult Treatment-Resistant Depression: A Double-Blind, Double-Randomization, Placebo-Controlled Study Biological Psychiatry November 4, 2015
and 7 more in the library