Strategies to Prolong Ketamine’s Efficacy in Adults with Treatment-Resistant Depression
Advances in Therapy April 30, 2021 Eric P. Mcmullen, Yena Lee, Orly Lipsitz et al.
Ketamine can rapidly improve symptoms in adults with treatment-resistant depression, but its effects often last only a median of 2–4 weeks. This systematic review examined strategies to prolong ketamine's acute antidepressant effects. After searching PubMed/MEDLINE, 22 studies were included: 10 randomized controlled trials, 8 open-label trials, 1 retrospective chart review, and 3 case reports. No treatment modality—including pharmacological interventions, psychotherapies, electroconvulsive therapy, or transcranial magnetic stimulation—significantly prolonged the effects of intravenous ketamine, except for repeat-dose IV ketamine itself. Maintenance esketamine is effective in responders. More multimodality strategies are needed.