COMMENTARY

New Data on Ketamine for Depression

Peter M. Yellowlees, MBBS, MD

Disclosures

December 10, 2015

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This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees.

Much has been written about the potential of ketamine as an antidepressant medication, but what is the evidence for its effectiveness and acceptability, especially when compared with other antidepressant agents? A team of investigators[1] from the University of Oxford, England, has performed a Cochrane review to assess the effects and review the acceptability of ketamine and other glutamate receptor modulators in comparison with placebo, other pharmacologically active agents, or electroconvulsive therapy in alleviating the acute symptoms of depression in people with unipolar major depressive disorder.

Twenty-five studies were included in the review. The authors found limited evidence for ketamine's efficacy over placebo up to 1 week, whereas few significant results were found for the remaining 10 glutamate receptor modulators. The authors noted that the evidence was limited by risk for bias and the small number of participants and that there were very limited data on such issues as suicidality, cognition, quality of life, and costs.

All included studies administered ketamine intravenously, and it is clear that as clinicians, the early promise of ketamine has yet to be fulfilled, and we should not be considering it in clinical practice at present.

This article is selected from Medscape Best Evidence. I'm Dr Peter Yellowlees.

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