Ketamine and other glutamate receptor modulators for depression in adults with unipolar major depressive disorder.
Cochrane Database of Systematic Reviews September 12, 2021 R. Dean, Claudia C. Hurducas, K. Hawton et al. 97 citations
A systematic review of 64 randomized controlled trials (5299 participants) examined glutamate receptor modulators for unipolar major depression. Ketamine and esketamine may reduce depressive symptoms more than placebo within 24 hours, but the evidence for ketamine is very uncertain, while esketamine shows moderate-certainty evidence for increased remission. No difference in dropout rates was found between these drugs and placebo. Evidence for other glutamate modulators (memantine, lanicemine, etc.) is very limited. The authors call for long-term trials and real-world monitoring to establish safety and efficacy.