Lancet psychiatry
January 1, 2018
Brooke L Short, J. Fong, V. Galvez et al.
551 citations
A systematic review of 60 studies on ketamine for depression found that after a single dose, psychiatric, psychotomimetic, cardiovascular, neurological, and other side effects were reported more often with ketamine than with placebo. The review identified a selective reporting bias: long-term safety and repeated-dose effects were poorly assessed in depression patients, even though such data exist for other groups (e.g., chronic pain patients and recreational users). The authors recommend large-scale trials with multiple doses and long-term follow-up to evaluate the safety of regular ketamine use.
Lancet psychiatry
November 1, 2022
S. Smith-Apeldoorn, J. Veraart, J. Spijker et al.
163 citations
Ketamine can quickly reduce depression in people who do not respond to other treatments, but the effect often fades. Maintenance ketamine treatment—repeated doses over time—may help sustain the antidepressant benefit. A review of three randomized trials, eight open-label studies, and 30 case series found that intravenous, intranasal, oral, and possibly intramuscular and subcutaneous maintenance ketamine are effective for sustaining antidepressant effects in treatment-resistant depression. Serious side effects such as tolerance, cognitive problems, addiction, and kidney or urinary issues appear uncommon. Despite limitations in the available studies, maintenance ketamine shows therapeutic potential. More controlled and naturalistic long-term research is needed to clarify its role in routine care.
Lancet psychiatry
May 1, 2017
I. Anderson, A. Blamire, T. Branton et al.
106 citations
Adding a low dose of the drug ketamine to the anesthetic used during electroconvulsive therapy (ECT) does not improve memory or speed recovery in severely depressed patients. In a randomized trial of 79 patients, those who received ketamine scored no better on a test of delayed verbal recall after four ECT sessions than those who received a placebo (saline). The ketamine group actually scored slightly lower on average, and the results rule out any more than a small to moderate benefit. Patients receiving ketamine also reported more adverse events, including transient psychological effects. The findings do not support using ketamine as a routine addition to ECT.