Mapping the Use of Ketamine in Treatment-Resistant Depression and Other Psychiatric Disorders: A Scoping Review of Practice Patterns, Efficacy, and Patient Demographic Trends
December 20, 2024 Amna Aslam, Kenneth Shinozuka, Owen S. Muir et al. 2 citations preprint
Ketamine, particularly intravenous (IV) ketamine, is increasingly used off-label for treatment-resistant depression (TRD), despite only esketamine being FDA-approved. A scoping review of two survey-based studies found IV administration is the most common method, with intramuscular and sublingual routes used less often. Patients are predominantly middle-aged (36-64 years), and financial barriers are notable due to limited insurance coverage and out-of-pocket costs. Geographic disparities limit access in rural areas. Private clinics offer more flexible treatment approaches than hospitals. The review emphasizes the need for standardized protocols, expanded insurance coverage, and further research due to variability in practices and absence of long-term outcome data.