Ketamine works as a rapid antidepressant for some but not all patients. In adolescents with treatment-resistant depression, those who had tried fewer antidepressant medications and augmentation treatments, had a shorter current depressive episode, and were currently taking a selective serotonin reuptake inhibitor (rather than a serotonin–norepinephrine reuptake inhibitor) were more likely to experience symptom improvement one and seven days after a single dose of ketamine. These findings are preliminary due to the small sample and multiple analyses, and more research is needed before using such predictors in clinical practice.
Interest in psychedelic therapies for adults is growing, with substances like MDMA for PTSD, psilocybin for treatment-resistant depression, and LSD for generalized anxiety disorder showing promise. However, research on these therapies in children and adolescents is limited, with no recent trials. Adolescents may still experiment with these substances recreationally or therapeutically as accessibility increases, raising significant concerns due to their vulnerability. The authors advocate for structured, safe, and well-controlled exploration of psychedelic therapies in adolescents.