Assessing the Efficacy of Single-Dose Ketamine for Major Depression

Researchers assessed the efficacy of single-dose ketamine in subgroups of those with major depression to determine if recurrent use of ketamine could be a feasible strategy to uphold therapeutic gains. They searched through electronic databases for published peer-reviewed randomized controlled trials through February 22, 2019 that contained single and repeated ketamine use in patients with major depression. From their search, 20 studies were selected for the meta-analysis. The greatest impact of ketamine compared with controls in lessening depressive symptoms was seen at 24 hours (standardized mean difference [SMD] = − 0.89; 95% CI − 1.24; − 0.53; p <.00001), but a considerable difference was seen for up to 7 days following a single dose. At 2 to 3 weeks of recurrent treatment of ketamine, a considerable decrease of depression severity scores was seen (SMD = − 0.70; 95% CI − 1.15; − 0.25 or SMD = − 0.81; 95% CI − 1.41; − 0.20 [depending on the used dosing regimen]; p ≤.009)vs placebo. From their assessment of the randomized controlled trials, researchers found that recurrent administration of ketamine is effective in tolerating primary antidepressant effects seen following single dosing.

Reference: Kryst J, Kawalec P, Mitoraj AM, Pilc A, Lasoń W, Brzostek T. Efficacy of single and repeated administration of ketamine in unipolar and bipolar depression: a meta-analysis of randomized clinical trials. Pharmacol Rep. 2020;72(3):543-562. doi:10.1007/s43440-020-00097-z

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