Side-effects associated with ketamine use in depression: a systematic review.
Brooke L Short, J. Fong, V. Galvez, William Shelker, C. Loo
Lancet psychiatry January 1, 2018 DOI: 10.1016/s2215-0366(17)30272-9 via Semantic Scholar
Summary
A systematic review of 60 studies on ketamine for depression found that after a single dose, psychiatric, psychotomimetic, cardiovascular, neurological, and other side effects were reported more often with ketamine than with placebo. The review identified a selective reporting bias: long-term safety and repeated-dose effects were poorly assessed in depression patients, even though such data exist for other groups (e.g., chronic pain patients and recreational users). The authors recommend large-scale trials with multiple doses and long-term follow-up to evaluate the safety of regular ketamine use.
Study at a glance
| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Patients with depression |
| Keywords | Medicine Psychology |
| Citations | 551 |
| Key finding | After acute dosing, side effects were more frequently reported after ketamine than after placebo, but there is selective reporting bias with limited assessment of long-term safety and repeated dosing. |
Abstract
This is the first systematic review of the safety of ketamine in the treatment of depression after single and repeated doses. We searched MEDLINE, PubMed, PsycINFO, and Cochrane Databases and identified 288 articles, 60 of which met the inclusion criteria. After acute dosing, psychiatric, psychotomimetic, cardiovascular, neurological, and other side-effects were more frequently reported after ketamine treatment than after placebo in patients with depresssion. Our findings suggest a selective reporting bias with limited assessment of long-term use and safety and after repeated dosing, despite these being reported in other patient groups exposed to ketamine (eg, those with chronic pain) and in recreational users. We recommend large-scale clinical trials that include multiple doses of ketamine and long-term follow up to assess the safety of long-term regular use.