Ketamine in the treatment of depression: opportunities and risks
Cutting Edge Psychiatry in Practice March 31, 2019 DOI: 10.65031/sgxf2983 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | Depression Esketamine Ketamine |
| Key findings | The authors report that small trials show ketamine reduces depressive symptoms within hours in patients whose depression is otherwise treatment-refractory, with responses lasting days. They argue that off-label use should be limited to cases where all other treatments have failed, a specialist center is available, and clinical trial participation is not possible. |
Abstract
There has been considerable interest in the potential of ketamine as a novel antidepressant with a unique mechanism of action. In a number of small trials, ketamine has been shown to lead to reductions in depressive symptoms within hours of administration in patients with symptoms that are otherwise refractory to treatment, with the antidepressant response lasting for days. Although the mechanism of action, as well as the efficacy and safety data, remain to be fully characterised, a number of centres have started to offer ketamine as an off-label treatment for depression. In tandem, a number of larger scale clinical trials are currently underway. At present, it is only advisable to consider the use of ketamine as an off-label treatment for depression in cases where all other treatments have failed, where access to a specialist centre with expertise in the use of ketamine as an antidepressant is available, and where the individual is not suitable to take part in a clinical trial of ketamine.
Comparable studies
Other narrative reviews on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine: a paradigm shift for depression research and treatment | 2019 | Review | |
| Rapid‐acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective | 2019 | Review | |
| Ketamine: A tale of two enantiomers | 2020 | Review | |
| Molecular mechanisms underlying the antidepressant actions of arketamine: beyond the NMDA receptor | 2021 | Review |