Ketamine for unipolar depression: A systematic review of efficacy and safety.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists – June 01, 2025
Source: PubMed
Summary
Within hours of treatment, ketamine can lift severe depression symptoms when traditional medications fail. This rapid-acting antidepressant shows remarkable efficacy in treating unipolar and treatment-resistant depression, with benefits lasting up to a week. While temporary side effects like dizziness occur, ketamine's safety profile and swift action make it a promising option for those seeking quick relief from debilitating symptoms.
Abstract
BackgroundUnipolar depression is a prevalent mental health disorder with persistent, treatment-resistant symptoms. Traditional antidepressants take weeks to show effects, underscoring the need for faster alternatives. Ketamine, originally an anaesthetic, has emerged as a rapid-acting antidepressant.ObjectiveThis systematic review evaluates ketamine's efficacy and safety in unipolar depression.MethodsA literature search (January 2000-May 2024) in PubMed, PsycINFO, and Cochrane Library included RCTs, CCTs, systematic reviews, meta-analyses, and observational studies on ketamine or esketamine in formally diagnosed individuals. Study characteristics, interventions, outcomes, and adverse events were analyzed, with quality and bias assessments.ResultsAcross 44 studies, ketamine significantly reduced depressive symptoms and suicidal ideation within hours, particularly in treatment-resistant cases, with effects lasting up to 1 week. Common side effects included transient dissociation, elevated blood pressure, nausea, and dizziness, while long-term safety remains uncertain.ConclusionsKetamine shows promise as a rapid antidepressant for treatment-resistant unipolar depression. However, long-term safety and optimal treatment protocols require further research. Careful clinical integration with monitoring is recommended.