Subcutaneous Ketamine in Depression: A Systematic Review
Frontiers in Psychiatry May 28, 2021 V. B. Cavenaghi, Leandro Paulino da Costa, A. Lacerda et al. 41 citations
Subcutaneous (SC) ketamine shows promise as a rapid and effective antidepressant for unipolar and bipolar depression, with response and remission rates ranging from 50 to 100% after single or multiple doses. Doses of 0.1 to 0.5 mg/kg of racemic ketamine and 0.5 to 1 mg/kg of esketamine were used, administered weekly or twice-weekly, often with dose titration. Side effects were temporary. This systematic review of 12 studies (two randomized trials, five case reports, and five retrospective studies) found SC ketamine to be a convenient and cost-effective route, particularly relevant for developing countries, though a meta-analysis was not possible due to heterogeneity. Further research comparing SC with intravenous and intranasal protocols is needed.