Ketamine treatment for anhedonia in unipolar and bipolar depression: a systematic review.
Aleksander Kwaśny, Julia Kwaśna, Alina Wilkowska, Joanna Szarmach, Jakub Słupski, Adam Włodarczyk, Wiesław Jerzy Cubała
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology September 1, 2024 DOI: 10.1016/j.euroneuro.2024.04.014 via PubMed
Summary
AI-generated from the abstractKetamine, a medication used for depression, may also reduce anhedonia (loss of interest or pleasure). A systematic review of 22 studies (4 randomized-controlled trials and 18 open-label trials) found that all reported alleviation of anhedonia symptoms after ketamine or esketamine administration, regardless of the number of infusions. Neuroimaging studies showed changes in functional connectivity linked to improvement. However, limitations include few placebo-controlled trials. The review suggests a potential anti-anhedonic effect of ketamine in depressed patients, likely through neuroplastic changes.
Study at a glance
| Characteristics | Systematic review Randomized Placebo-controlled Open-label Peer reviewed |
|---|---|
| Population | Patients with depression |
| Interventions | Ketamine Esketamine |
| Topics | Depression Esketamine Ketamine |
| Keywords | Bipolar depression Ketamine therapy Anhedonia treatment |
| Citations | 24 |
| Key finding | All 22 studies reported alleviation of anhedonia symptoms following ketamine or esketamine administration, suggesting a potential anti-anhedonic effect. |
Abstract
Ketamine, an N-methyl-D-aspartate receptor antagonist, is a racemic mixture of esketamine and arketamine used to treat unipolar and bipolar depression. Preliminary reports indicate that it may be beneficial for depressed patients reporting symptoms of anhedonia. In this systematic review we aim to assess and analyze the existing body of evidence regarding the therapeutic effects of ketamine on the domain of anhedonia. Electronic databases (PubMed, APA Psycinfo and Web of Science) were searched from inception to November 2023. Protocol was registered in PROSPERO under the identifier CRD42023476603. A total of twenty-two studies, including four randomized-controlled trials and eighteen open-label trials were included. All studies reported alleviation of anhedonia symptoms following ketamine or esketamine administration, regardless of the number of infusions. Several important limitations were included, first and foremost low number of placebo-controlled randomized-controlled trials. This review indicates a potential anti-anhedonic effect of ketamine in patients with depression. Several trials used neuroimaging techniques which confirm ketamine's effect on functional connectivity correlating with the improvement in anhedonia. Despite considerable variations in methodology and the specific brain regions investigated, these studies collectively point towards ketamine's neuroplastic effects in mitigating anhedonia.