Ketamine for unipolar depression: A systematic review of efficacy and safety.
Level 1 - systematic review of randomized trials
Systematic review synthesizing randomized trials along with observational and secondary studies
PubMed 40237571 · doi:10.1177/10398562251328805
What was done
A systematic search was conducted across PubMed, PsycINFO, and the Cochrane Library (January 2000 to May 2024) to evaluate the efficacy and safety of ketamine or esketamine in individuals formally diagnosed with unipolar depression. The review synthesized 44 studies, encompassing randomized controlled trials (RCTs), controlled clinical trials (CCTs), systematic reviews, meta-analyses, and observational studies, while performing quality and risk-of-bias assessments.
What was found
Ketamine significantly reduced depressive symptoms and suicidal ideation within hours of administration, particularly in treatment-resistant unipolar depression, with benefits lasting up to 1 week. Commonly reported adverse events included transient dissociation, elevated blood pressure, nausea, and dizziness. The abstract provides no specific numerical values, effect sizes, or response rates.
Why it matters
This synthesis supports ketamine as an effective rapid-acting intervention for acute depressive episodes and suicidal ideation where traditional antidepressants have failed. It highlights the clinical utility for rapid stabilization while noting the current gap in evidence for long-term maintenance.
Limits
The abstract reports no numerical data, confidence intervals, or total participant counts (n). The synthesis aggregates diverse study designs including observational studies and secondary reviews alongside RCTs, creating substantial methodological heterogeneity. Long-term safety, sustained efficacy beyond one week, and optimal treatment protocols remain unestablished.
Cited by
- supports Ketamine demonstrates immediate and profound antidepressant effects in treatment-resistant depressed patients, but these effects are short-lived.