OBJECTIVE: Narrative review of the literature on the efficacy and safety of subanaesthetic doses of ketamine for the treatment of depression. METHOD: Medline and PubMed databases were searched up to October 2012 using appropriate keywords. RESULTS: The studies consistently report substantial efficacy with high response and remission rates from 4 to 72 hours (averages 77% and 43%, respectively) from single doses, though not all patients respond to ketamine. Early relapse is common. While the usual procedure involves the administration of intravenous ketamine at a dose of 0.5 mg/kg over 40 minutes, some preliminary evidence suggests other dosing regimens and routes of administration may be useful or even better. Repeated doses and maintenance pharmacological treatments have been investigated in order to prolong the antidepressant effects, with only modest success. CONCLUSIONS: Current research on the antidepressant effects of ketamine has consistently shown rapid and substantial improvement in mood in the majority of patients. However, these effects have often been found to be short-lived. Future research should focus on identifying predictors of response (e.g. clinical, genetic, pharmacokinetic, environmental), examining different dosing regimens and routes of administration, and strategies to maintain the antidepressant response.
OBJECTIVE: Narrative review of the literature on the efficacy and safety of subanaesthetic doses of ketamine for the treatment of depression. METHOD: Medline and PubMed databases were searched up to October 2012 using appropriate keywords. RESULTS: The studies consistently report substantial efficacy with high response and remission rates from 4 to 72 hours (averages 77% and 43%, respectively) from single doses, though not all patients respond to ketamine. Early relapse is common. While the usual procedure involves the administration of intravenous ketamine at a dose of 0.5 mg/kg over 40 minutes, some preliminary evidence suggests other dosing regimens and routes of administration may be useful or even better. Repeated doses and maintenance pharmacological treatments have been investigated in order to prolong the antidepressant effects, with only modest success. CONCLUSIONS: Current research on the antidepressant effects of ketamine has consistently shown rapid and substantial improvement in mood in the majority of patients. However, these effects have often been found to be short-lived. Future research should focus on identifying predictors of response (e.g. clinical, genetic, pharmacokinetic, environmental), examining different dosing regimens and routes of administration, and strategies to maintain the antidepressant response.
Authors: Ying Xu; Maree Hackett; Gregory Carter; Colleen Loo; Verònica Gálvez; Nick Glozier; Paul Glue; Kyle Lapidus; Alexander McGirr; Andrew A Somogyi; Philip B Mitchell; Anthony Rodgers Journal: Int J Neuropsychopharmacol Date: 2016-04-20 Impact factor: 5.176
Authors: Jeffery N Talbot; Laura M Geffert; Jessica E Jorvig; Ruben I Goldstein; Cienna L Nielsen; Nicholas E Wolters; Mary Ellen Amos; Caitlin A Munro; Elizabeth Dallman; Maddalena Mereu; Gianluigi Tanda; Jonathan L Katz; Martín Indarte; Jeffry D Madura; Hailey Choi; Rehana K Leak; Christopher K Surratt Journal: Pharmacol Biochem Behav Date: 2016-08-26 Impact factor: 3.697
Authors: Brian M Radvansky; Khushbu Shah; Anant Parikh; Anthony N Sifonios; Vanny Le; Jean D Eloy Journal: Biomed Res Int Date: 2015-10-01 Impact factor: 3.411