JAMA Psychiatry
June 1, 2023
Vikas Menon, Natarajan Varadharajan, Abdul Faheem et al.
50 citations
Electroconvulsive therapy (ECT) appears more effective than ketamine for treating major depressive episodes in adults, though the evidence is limited by small studies. A meta-analysis of five randomized trials (141 ketamine patients, 137 ECT patients) found ECT produced significantly higher response and remission rates one week after treatment. ECT was 27% more likely to achieve response and 43% more likely to achieve remission than ketamine. In methodologically stronger trials, ECT showed a moderate advantage over ketamine on depression rating scales. No significant differences emerged between treatments for number of sessions needed or cognitive side effects. The authors caution that conclusions are tempered by the small number and size of existing trials.
Acta Psychiatrica Scandinavica
December 3, 2024
Vikas Menon, Parthasarathy Ramamurthy, Sandesh Venu et al.
15 citations
A meta-analysis of six randomized controlled trials (total 427 participants) found that psilocybin-assisted therapy produced significantly greater reductions in depression ratings than comparator treatments for major depressive disorder, including treatment-resistant depression. The effect was medium to large (standardized mean difference −0.72) at one week and persisted through six weeks. Response and remission rates were roughly 3.4 to 3.7 times higher with psilocybin therapy. However, the therapy carried a small increased risk of any adverse event, particularly headache and dizziness. Low heterogeneity across studies supports the reliability of these findings.
Asian journal of psychiatry
September 1, 2024
Pn Suresh Kumar, Vikas Menon, Chittaranjan Andrade
12 citations
In outpatients with treatment-resistant depression, oral ketamine was better tolerated than intravenous (IV) ketamine, with a lower dropout rate (26.7% vs 54.8%). Depression ratings and response and remission rates did not differ between the two groups at day 14 or day 30. Adverse events such as headache (56.7% vs 74.2%) and drowsiness (0.0% vs 22.6%) were less common with oral ketamine. However, conclusions about relative antidepressant efficacy cannot be drawn due to the high dropout rate in the IV group.
Asian journal of psychiatry
April 1, 2025
Asif Seraj, Mohammed Reyazuddin, R K Gaur et al.
11 citations
A single oral dose of racemic ketamine (3 mg/kg) reduced suicidal ideation and depression symptoms more than an active placebo (oral midazolam, 0.3 mg/kg) in adults with major depressive disorder. Suicidal ideation scores were lower in the ketamine group at 4 hours, day 3, and day 7; depression scores were lower at 4 hours and day 3. By day 7, 25% of ketamine-treated patients responded to treatment (vs. 0% with midazolam), and 5% achieved remission (vs. 0%). Side effects such as nausea, emotional disturbance, and depersonalization were more common with ketamine but not treatment-limiting. Oral racemic ketamine appears reasonably well-tolerated and rapidly effective for suicidal ideation and depression.
JAMA Psychiatry
December 1, 2023
Chittaranjan Andrade
Ketamine, an anesthetic with a history of recreational use, is being investigated for new on- and off-label indications across medical disciplines, including treatment-resistant depression, chronic pain, and other conditions. The article discusses the expanding experimental and clinical applications of ketamine, highlighting its potential benefits and risks as research progresses.