Comparative safety and tolerability of ketamine and esketamine for major depressive disorder: a systematic review and meta-analysis.
Frontiers in pharmacology January 1, 2025 Haoning Guo, Liling Tang, Miaoquan He et al. 5 citations
A systematic review and meta-analysis of 47 studies found that both ketamine and esketamine are associated with a higher rate of adverse events than placebo in treating major depressive disorder, but serious adverse events were not significantly increased. Common side effects include dizziness, dissociation, nausea, vertigo, and blurred vision, which are dose-dependent and transient. Esketamine showed a potential tolerability advantage over ketamine, with higher number needed to harm values, meaning fewer people experience side effects per dose. No significant long-term issues were found for cognitive function, bladder symptoms, or addiction-related measures. Direct head-to-head trials are needed to confirm these findings.