The Journal of Clinical Psychiatry
April 15, 2019
Joshua D. Rosenblat, André F. Carvalho, Madeline Li et al.
111 citations
Oral ketamine shows significant antidepressant effects with good tolerability, but its effects are not as rapid as intravenous ketamine. In two randomized controlled trials, significant reductions in depressive symptoms were observed only after 2-6 weeks of treatment. Rapid antidepressant effects within 24 hours, antisuicide effects, and efficacy in treatment-resistant depression were reported only in retrospective studies. Dosages ranged from 0.5 to 7.0 mg/kg, with most studies using 1-2 mg/kg every 1-3 days. No clinically significant adverse effects were reported. The review concludes that antisuicide effects and efficacy in treatment-resistant depression have yet to be demonstrated in well-designed trials.
Cancers
January 7, 2023
Joshua D. Rosenblat, Froukje E. deVries, Zoe Doyle et al.
49 citations
In patients with advanced cancer and major depressive disorder, three flexible doses of intranasal ketamine (50–150 mg) over one week produced rapid antidepressant effects. By day 8, 70% of participants showed a response (depression scores reduced by more than half) and 45% achieved remission. Depression scores dropped from an average of 31 to 11, a decrease of 20 points. Some benefit persisted into the second week without further doses. Side effects were mostly mild and temporary, including fatigue, dissociation, nausea, altered taste, and headaches; one participant withdrew due to a negative dissociative episode. Larger controlled trials are warranted.
Pilot and Feasibility Studies
October 28, 2025
Candice Richardson, Cindy Chan, Emily Macgregor et al.
1 citation
A new therapy combining psilocybin with evidence-based psychotherapies for people with advanced cancer, called PEARL therapy, will be tested in an open-label trial with 15 participants. The study will assess whether the therapy is acceptable, feasible, and safe by tracking recruitment, retention, adherence, and serious adverse events, and by collecting self-report questionnaires and qualitative interviews. This research aims to inform policy, training, and clinical guidelines for psychedelic-assisted therapies, which may improve quality of life for those with advanced disease.
Journal of pain and symptom management
August 1, 2026
Stefan Aguiar, Mary Makarious, Orly Lipsitz et al.
In adults with advanced cancer receiving palliative care, intranasal ketamine was associated with clinically meaningful improvements in existential distress, anxiety, symptom burden, and quality of life. Fifteen participants who completed three doses of ketamine showed improvements exceeding established minimal clinically important differences on measures of anxiety, death and dying distress, overall symptoms, and quality of life. Improvements in existential well-being were larger than those in physical symptoms. Changes in depression did not significantly correlate with changes in existential distress outcomes, suggesting ketamine may have independent effects on multiple dimensions of distress in this population.