Ketamine for unipolar major depression: critical examination of antidepressant effects
BJPsych Advances May 1, 2025 DOI: 10.1192/bja.2024.84 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Commentary Randomized Peer reviewed |
|---|---|
| Interventions | Ketamine saline midazolam |
| Duration | 24–72 h |
| Topics | Depression Esketamine Ketamine |
| Key points | The authors report that intravenous ketamine improves antidepressant response compared with intravenous saline, and to a lesser extent compared with intravenous midazolam, within 24 to 72 hours in unipolar major depressive disorder. They caution that masking concerns and study heterogeneity limit the evidence, so further research is needed to confirm ketamine's clinical potential. |
Abstract
SUMMARYThis critical appraisal of a Cochrane Review assesses the efficacy of ketamine for treating unipolar major depressive disorder. The review included 31 randomised controlled trials involving ketamine. Results indicate that intravenous (i.v.) ketamine significantly improves antidepressant response compared with i.v. saline and, to a lesser extent, i.v. midazolam within 24–72 h. However, the evidence is constrained by performance bias owing to masking (‘blinding’) concerns and study heterogeneity, necessitating further robust research to confirm ketamine's clinical potential.