An Update on the Efficacy of Single and Serial Intravenous Ketamine Infusions and Esketamine for Bipolar Depression: A Systematic Review and Meta-Analysis
Brain Sciences December 22, 2023 Nicolas A. Nunez, Boney Joseph, Rakesh Kumar et al. 20 citations
Ketamine can rapidly reduce depression and suicidal thoughts in treatment-resistant depression, but its effectiveness for bipolar depression is less certain. An updated systematic review and meta-analysis of 11 studies, including 7 in the meta-analysis, found that a single ketamine infusion significantly improved depression symptoms measured by the MADRS scale at 1 and 2 days. Non-randomized studies showed a 53% response rate at study endpoint. Response and remission rates were similar for single versus serial infusions. The rate of switching to mania was about 2.4%. Evidence for esketamine in bipolar depression remains limited and based on small, non-randomized studies.