Journal of Psychiatric Research
May 1, 2022
Yazen Alnefeesi, D. Chen-Li, Ella Krane et al.
177 citations
Ketamine shows substantial real-world antidepressant effects in treatment-resistant depression, with about 45% of patients responding and 30% achieving remission, based on a systematic review and meta-analysis of 79 studies involving 2665 patients. The effect varies considerably among individuals; more treatment-resistant cases remit less often, but response rates do not differ. The therapeutic benefit does not significantly decline with repeated treatments, indicating that even the most treatment-resistant patients may benefit and that mid-to-long term treatment is effective for many.
Journal of Psychiatric Research
December 11, 2020
Jiaqi Xiong, Orly Lipsitz, D. Chen-Li et al.
122 citations
A meta-analysis of nine randomized controlled trials (197 participants) found that a single dose of intravenous ketamine or intranasal esketamine is associated with large reductions in suicidal thoughts at 2, 4, and 24 hours after administration. The pooled effect size for intravenous racemic ketamine at 24 hours was 1.035, and for intranasal esketamine it was 1.309. No trials of intramuscular, oral, or sublingual ketamine reported anti-suicidal ideation effects suitable for quantitative analysis. The authors suggest that further studies are needed to evaluate these other routes of delivery and to compare formulations.
World Journal of Biological Psychiatry
January 18, 2023
Shakila Meshkat, Sipan Haikazian, Joshua D. Di Vincenzo et al.
61 citations
Oral ketamine shows potential as an antidepressant for unipolar and bipolar depression, based on a systematic review of 22 studies involving 2336 patients. All included studies reported significant improvement after ketamine administration, and it was well tolerated without serious adverse events. However, the review identified important limitations, including a small number of randomized clinical trials (only four) and a high risk of bias in those trials due to analysis methods and adverse events monitoring. Ketamine dosages ranged from 0.5 to 1.25 mg/kg, with administration frequency from daily to monthly. Further research with larger samples and longer follow-up is needed to determine its antisuicidal effect and efficacy in treatment-resistant depression.
Therapeutic Advances in Psychopharmacology
January 1, 2023
Farhan Fancy, Sipan Haikazian, Danica E. Johnson et al.
23 citations
Ketamine given intravenously at subanesthetic doses (0.5–0.75 mg/kg) or as esketamine (28–84 mg) appears safe and effective as an add-on treatment for bipolar depression when combined with a mood stabilizer. Across eight studies (235 participants), 48% of those receiving ketamine achieved at least a 50% reduction in depression severity, compared with 5% on placebo. Real-world response rates were lower (30%) than in clinical trials (63%). Some studies noted reductions in suicidal ideation, though not all findings were statistically significant. Ketamine was generally well tolerated, but 2% of participants (five receiving ketamine) developed hypomanic or manic symptoms, and significant dissociative effects occurred at 40 minutes in some trials.