Ketamine: A Review for Clinicians
Gerard Sanacora, Rachel B. Katz
FOCUS: The Journal of Lifelong Learning in Psychiatry July 1, 2018 DOI: 10.1176/appi.focus.20180012 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Case report Peer reviewed |
|---|---|
| Topics | Anxiety Ketamine Esketamine |
| Keywords | Intensive care medicine Clinical trial Antidepressant Depression economics Suicidal ideation Poison control Suicide prevention Medical emergency |
| Citations | 16 |
| Key findings | Ketamine offers rapid but often short-lived antidepressant effects, with multiple infusions potentially providing sustained relief, though data on efficacy and safety remain inadequate. |
Abstract
A growing series of clinical trials and case series now suggest that ketamine-originally used as an anesthetic agent-potentially offers an exciting new treatment option for severe depression. Increasing numbers of studies show that ketamine can provide prompt relief for many depressed patients, including those with severe treatment-refractory depression. Although the effects of a single treatment are commonly short-lived, multiple infusion protocols may offer sustained relief. The uniquely rapid onset of antidepressant action raises the potential for ketamine use in a variety of clinical situations, including the prevention or shortening of hospital stays, the treatment of acute suicidal ideation, and the facilitation of medication crossovers. Ketamine, in combination with other multimodal treatment approaches, including psychotherapy, may further augment response effect and duration. Promises of efficacy have led to increasingly unbridled use to treat a variety of psychiatric disorders, with diverse approaches and treatment environments, despite inadequate data demonstrating the true clinical efficacy and safety of the various protocols or a thorough understanding of mechanisms of action. This article briefly reviews the history of ketamine's development as a potential antidepressant, current hypotheses related to its mechanisms of action, and existing evidence for its safety and efficacy with a focus on clinicians' interests.
Comparable studies
Other narrative reviews on ketamine for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders | 2017 | Review and consensus statement | |
| 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 |
Citations in the library
Cited by 4
- The Antidepressant Effect of Ketamine Is Dampened by Concomitant Benzodiazepine Medication Frontiers in Psychiatry August 28, 2020
- Blood pressure changes during ketamine infusion for the treatment of depression. General Hospital Psychiatry 2024
- Efficacy of Ketamine Therapy in the Treatment of Refractory Major Depressive Disorder Journal of Exploratory Research in Pharmacology July 25, 2023
- Optimizing ketamine dosing strategies across diverse clinical applications: a comprehensive review. Annals of Medicine and Surgery July 18, 2025
Cites 43
- A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Archives of General Psychiatry August 1, 2006
- Subanesthetic Effects of the Noncompetitive NMDA Antagonist, Ketamine, in Humans Archives of General Psychiatry March 1, 1994
- mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA Antagonists Science August 19, 2010
- Activation of Glutamatergic Neurotransmission by Ketamine: A Novel Step in the Pathway from NMDA Receptor Blockade to Dopaminergic and Cognitive Disruptions Associated with the Prefrontal Cortex Journal of Neuroscience April 15, 1997
- Synaptic Dysfunction in Depression: Potential Therapeutic Targets Science October 4, 2012
and 38 more in the library