The Role of Ketamine in the Treatment of Bipolar Depression: A Scoping Review.
Brain sciences – June 04, 2023
Source: PubMed
Summary
Ketamine shows promise for treating bipolar depression, particularly for patients who do not respond to standard treatments, affecting about 25% of individuals. A review of 10 clinical studies, including 5 randomized trials, indicates that ketamine is generally well-tolerated with low risks of triggering mania. It demonstrated some effectiveness in reducing depressive symptoms and suicidality. These findings suggest that ketamine could be a viable option for treatment-resistant bipolar depression, highlighting the need for further exploration into its long-term benefits and safety.
Abstract
Bipolar depression remains a clinical challenge with a quarter of patients failing to respond to initial conventional treatments. Although ketamine has been extensively studied in unipolar depression, its role in bipolar disorder remains inconclusive. The aim of our scoping review was to comprehensively synthesize the current clinical literature around ketamine use in bipolar depression. A total of 10 clinical studies (5 randomized controlled trials and 5 open label studies) were selected. The preliminary evidence, albeit weak, suggests that ketamine is a promising treatment and calls for further interest from the research community. Overall, ketamine treatment appeared to be tolerable with minimal risk for manic/hypomanic switching and showed some effectiveness across parameters of depression and suicidality. Moreover, ketamine is a potential treatment agent in patients with treatment-resistant bipolar depression with promising data extracted from extant controlled trials and real-world effectiveness studies. Future studies are needed to identify ketamine's role in acute and maintenance treatment phases of bipolar depression. Moreover, future researchers should study the recurrence prevention and anti-suicidal effects of ketamine in the treatment of bipolar depression.