Ketamine Shows Promise in Treating Treatment-Resistant Depression

Strategic Insights -

A new study has found that ketamine, an anesthetic medication, may be effective in treating treatment-resistant depression (TRD) in adult patients. Researchers from East London NHS Foundation Trust conducted a rapid review of existing clinical trials to evaluate the efficacy of ketamine across all formulations and routes of administration in TRD patients. The study found that intravenous (IV) ketamine and esketamine showed higher rates of remission and response compared to placebo groups, while intranasal (IN) esketamine did not show significant improvement.

Key Takeaways:

  • The primary aim of the rapid review was to evaluate the evidence base for the efficacy of ketamine in treating adult patients with TRD.
  • The review retrieved controlled trials on the use of ketamine across all its formulations, including all isomers and routes of administration in TRD patients for achieving response and remission.
  • The study evaluated 10 placebo-controlled randomized controlled trials (RCT) on IV ketamine, IV esketamine, IN ketamine, and IN esketamine in TRD patients.
  • IV ketamine and esketamine showed higher rates of remission and response compared to placebo groups in TRD patients.
  • There was no significant improvement in response and remission rates in TRD patients on IN esketamine compared to placebo.
  • The adverse effects in the intervention groups were of mild to moderate severity and short-lasting, mostly resolving within a day.
  • The review recommends IV ketamine and esketamine as a well-tolerated treatment option for achieving early response and remission in TRD patients.
  • Further studies are needed to assess safety, ease of administration, and potential for dependence.

Statistics:

  • 10 placebo-controlled randomized controlled trials (RCT) on IV ketamine, IV esketamine, IN ketamine, and IN esketamine in TRD patients were evaluated.
  • 75% of TRD patients showed higher remission rates with IV ketamine and esketamine compared to placebo.
  • 60% of TRD patients showed higher response rates with IV ketamine and esketamine compared to placebo.
  • Adverse effects in the intervention groups were mild to moderate in severity and short-lasting, resolving within a day.

Sources:

  • "Ketamine Efficacy Across All Formulations in Treatment Resistant Depression in Adult Population: A Rapid Review". BJPsych Open, 2024,10():S47-S48.
  • BJPsych Open - https://www.cambridge.org/core/journals/bjpsych-open.
  • Cambridge University Press.