Serial Ketamine Infusions as Adjunctive Therapy to Inpatient Care for Depression
A. Jelovac, Cathal Mccaffrey, Masashi Terao, E. Shanahan, Emma Whooley, Kelly Mcdonagh, Sarah Mcdonogh, Orlaith Loughran, Ellie Shackleton, Anna Igoe, Sarah Thompson, Enas Mohamed, D. Nguyen, Ciaran O’neill, Cathal Walsh, Declan M. Mcloughlin
JAMA psychiatry October 22, 2025 DOI: 10.1001/jamapsychiatry.2025.3019 via Semantic Scholar
Summary
Repeated intravenous ketamine infusions are no more effective than a placebo (midazolam) for reducing depressive symptoms in inpatients with moderate to severe depression. In a randomized clinical trial, there was no statistically significant difference between the ketamine and midazolam groups on the primary outcome of depression severity at the end of treatment. No significant differences were found on secondary measures of efficacy, cognition, economic outcomes, or quality of life. These results do not support a superior antidepressant effect for serial intravenous ketamine as an addition to usual inpatient care.
Study at a glance
| Characteristics | Randomized clinical trial Peer reviewed |
|---|---|
| Population | Inpatients with moderate to severe depression |
| Keywords | Medicine |
| Citations | 13 |
| Key finding | Repeated intravenous ketamine was not superior to midazolam in reducing depressive symptoms among inpatients with moderate to severe depression. |
Abstract
Key Points Question For inpatients with moderate to severe depression, is repeated intravenous ketamine superior to a psychoactive placebo (midazolam) in reducing depressive symptoms? Findings In this randomized clinical trial, there was no statistically significant difference in the primary outcome, end-of-treatment Montgomery-Åsberg Depression Rating Scale score, between the ketamine and midazolam groups. No significant differences were observed on secondary efficacy, cognitive, economic, or quality-of-life outcomes. Meaning These findings do not support a superior antidepressant effect for serial intravenous ketamine infusions as an adjunctive therapy to usual inpatient care for moderate to severe depression.