The effects of ketamine and classic hallucinogens on neurotrophic and inflammatory markers in unipolar treatment-resistant depression: a systematic review of clinical trials.
Giordano Novak Rossi, Jaime E C Hallak, Glen Baker, Serdar M Dursun, Rafael G Dos Santos
European archives of psychiatry and clinical neuroscience February 1, 2023 DOI: 10.1007/s00406-022-01460-2 via PubMed
Summary
AI-generated from the abstractA systematic review of clinical trials examined whether the antidepressant effects of ketamine and classical hallucinogens (ayahuasca) in treatment-resistant depression are linked to changes in inflammatory and neurotrophic biomarkers. Twelve studies involving 587 participants were analyzed, including two with oral ayahuasca and ten with ketamine. Results across all measured biomarkers were contradictory and inconclusive. The authors conclude that larger randomized controlled trials are needed to determine whether peripheral biomarkers can reliably indicate or measure the antidepressant effects of these substances.
Study at a glance
| Characteristics | Systematic review Randomized Peer reviewed |
|---|---|
| Sample size | 587 |
| Population | Adults with unipolar treatment-resistant depression |
| Interventions | ketamine ayahuasca |
| Dose | 1 mL/kg oral ayahuasca; mostly intravenous 0.5 mg/kg ketamine |
| Topics | Depression Ketamine |
| Keywords | Bdnf Biomarkers Psychedelics |
| Citations | 14 |
| Key finding | Changes in peripheral inflammatory and neurotrophic biomarkers after ketamine and classical hallucinogen administration were contradictory and inconclusive, providing no clear evidence that these biomarkers can indicate or measure antidepressant effects. |
Abstract
Although results are still preliminary, ketamine and classical hallucinogens have shown promise in recent years as novel, fast-acting antidepressants, especially for the treatment of unipolar treatment-resistant depression (TRD). Depression also seems to be related to abnormal levels of peripheral inflammatory and neurotrophic biomarkers, which may one day help to diagnose of this disorder. In this context, this systematic review of clinical trials evaluated the current evidence that relates the antidepressant effects of ketamine and classical hallucinogens on TRD with changes in inflammatory and neurotrophic biomarkers. Twelve studies were found (n = 587), 2 with oral ayahuasca (1 mL/kg) and 10 with ketamine (mostly intravenous 0.5 mg/kg) administration. Results for all biomarkers assessed were contradictory and thus inconclusive. Randomized controlled trials with bigger samples and higher statistical power are warranted to clarify if peripheral biomarkers can confidently be used to indicate and measure ketamine's and classical hallucinogens' antidepressant effect. The PROSPERO ID for this study is CRD42021249089.