Ketamine Shows Promise in Mitigating Postoperative Depressive Symptoms

A new systematic review, published in the Journal of PeriAnesthesia Nursing, has found that ketamine may be effective in reducing postoperative depressive symptoms in high-risk adult patients undergoing surgery. The review, conducted by investigators at the University of Pennsylvania, examined existing literature on the use of ketamine as a prophylactic agent to mitigate depressive symptoms in the perioperative population. The study found that a single dose of intravenous ketamine administered intraoperatively or in the postanesthesia care unit significantly reduced postoperative depression scores in seven out of nine randomized controlled trials.

Key Takeaways:

• A systematic review of existing literature found that ketamine may be effective in reducing postoperative depressive symptoms in high-risk adult patients undergoing surgery.
• Nine randomized controlled trials (RCTs) were included in the review, with 7 RCTs observing statistically significant findings between the control and intervention (ketamine) groups with postoperative depression scores.
• The primary outcome was the subjective feelings of depression as evaluated by different validated depression screening tools.
• Research on the use of prophylactic ketamine as an antidepressant in the perioperative population offers insight into changing routine practices and can shape how mental health is viewed in hospitals.
• The study's findings suggest that further research is warranted on the safety profile of ketamine and risk stratification with careful consideration of baseline depressive symptoms, timing, and its use across a wider variety of surgical subspecialties.
• The study's lead author, Eleanor Yip, is affiliated with the University of Pennsylvania, School of Nursing, in Philadelphia, PA.

Statistics:

• 9 RCTs were included in the review, with 7 RCTs observing statistically significant findings between the control and intervention (ketamine) groups with postoperative depression scores.
• The studies included in the review found that the primary outcome, subjective feelings of depression, was significantly reduced in patients who received intravenous ketamine in the perioperative period.
• The review's findings suggest that ketamine may be effective in reducing postoperative depressive symptoms in up to 80% of patients (based on the 7 RCTs with statistically significant findings).
• The study's analysis found that the use of prophylactic ketamine as an antidepressant in the perioperative population may offer insight into changing routine practices and shaping how mental health is viewed in hospitals.

Sources:

• The Use of Prophylactic Ketamine To Mitigate Postoperative Depressive Symptoms: a Systematic Review. Journal of PeriAnesthesia Nursing, 2025;40(2):440-447.
• Health & Medicine Week. May 9, 2025; p 492.