Ketamine for Depression: Where Do We Go from Here
Biological Psychiatry, 06/20/2012
aan het Rot M et al. – Ketamine administration has usually involved an anaesthesiologist infusing a single, subanesthetic, intravenous dose, and required hospitalization for at least 24 hours postinfusion. Response rates in the open–label investigations and controlled trials have ranged from 25% to 85% at 24 hours postinfusion and from 14% to 70% at 72 hours postinfusion. Although adverse effects have generally been mild, some patients have experienced brief changes in blood pressure, heart rate, or respiratory rate.
- Since publication of the first randomized controlled trial describing rapid antidepressant effects of ketamine, several reports have confirmed the potential utility of this dissociative anesthetic medication for treatment of major depressive episodes, including those associated with bipolar disorder and resistant to other medications and electroconvulsive therapy.
- These reports have generated several questions with respect to who might respond to ketamine, how, and for how long.
- To start answering these questions.
- The authors used PubMed.gov and ClinicalTrials.gov to perform a systematic review of all available published data on the antidepressant effects of ketamine and of all recently completed, ongoing, and planned studies.
- To date, 163 patients, primarily with treatment-resistant depression, have participated in case studies, open-label investigations, or controlled trials.
- All controlled trials have used a within-subject, crossover design with an inactive placebo as the control.