Ketamine Use in Critically Ill Patients: Insights into Depressive Symptoms and Hemodynamic Changes.
Journal of intensive care medicine April 16, 2026 Vrutti Patel, Saurabh Sujanyal, Lekhya Raavi et al.
Subanesthetic doses of ketamine improved specific depressive symptoms in critically ill intensive care unit patients without causing significant hemodynamic instability. In a retrospective study of 34 adults, including 18 solid organ transplant recipients, ketamine infusions (0.3-0.75 mg/kg over 40 minutes on three consecutive days) were associated with improvement in apparent sadness (90.0% vs 52.2%) and reported sadness (95.0% vs 59.1%). Among transplant recipients, improvement in apparent sadness remained significant (80.0% vs 41.7%). Heart rate increased transiently at 15-30 minutes post-infusion but returned to baseline by 60-90 minutes. Adverse effects included anxiety (12.5%), restlessness or agitation (10.4%), and dissociation (8.16%). These findings support ketamine's potential as a rapid-acting antidepressant in the ICU.