A systematic review and meta-analysis of the efficacy of intravenous ketamine infusion for treatment resistant depression: January 2009 - January 2019.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 12 2020
Historique:
received: 12 02 2020
revised: 15 04 2020
accepted: 01 09 2020
entrez: 17 10 2020
pubmed: 18 10 2020
medline: 6 3 2021
Statut: ppublish

Résumé

Sub-anaesthetic administration of ketamine is an emerging practice in patients presenting treatment resistant depression (TRD), however several outstanding questions have yet to be answered. To evaluate the effect of intravenous ketamine infusion for patients presenting TRD on depression scores, clinical remission and response rates, and to assess its efficacy over both time and frequency. Five databases were searched up to January 4 Twenty-eight studies in 35 publications were included. A strong ketamine effect was observed within 4 hours following a single infusion, and peaked at 24 hours. Ketamine's effectiveness was still present, yet somewhat diminished, 7 days post-infusion. Multiple infusions resulted in an enhanced and prolonged ketamine effect. Due to insufficient data, long-term safety and efficacy of ketamine utilisation in patients presenting TRD are yet to be investigated. Results provide support for the use of ketamine in the rapid management of depressive symptoms. While ketamine appears promising in the short-term treatment of TRD, more clinical and experimental data is needed with regards to the efficacy, tolerance and security of long-term administration of ketamine.

Sections du résumé

BACKGROUND
Sub-anaesthetic administration of ketamine is an emerging practice in patients presenting treatment resistant depression (TRD), however several outstanding questions have yet to be answered.
OBJECTIVE
To evaluate the effect of intravenous ketamine infusion for patients presenting TRD on depression scores, clinical remission and response rates, and to assess its efficacy over both time and frequency.
METHODS
Five databases were searched up to January 4
RESULTS
Twenty-eight studies in 35 publications were included. A strong ketamine effect was observed within 4 hours following a single infusion, and peaked at 24 hours. Ketamine's effectiveness was still present, yet somewhat diminished, 7 days post-infusion. Multiple infusions resulted in an enhanced and prolonged ketamine effect.
LIMITS
Due to insufficient data, long-term safety and efficacy of ketamine utilisation in patients presenting TRD are yet to be investigated.
CONCLUSIONS
Results provide support for the use of ketamine in the rapid management of depressive symptoms. While ketamine appears promising in the short-term treatment of TRD, more clinical and experimental data is needed with regards to the efficacy, tolerance and security of long-term administration of ketamine.

Identifiants

pubmed: 33065824
pii: S0165-0327(20)32702-6
doi: 10.1016/j.jad.2020.09.007
pii:
doi:

Substances chimiques

Ketamine 690G0D6V8H

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

831-841

Informations de copyright

Copyright © 2020. Published by Elsevier B.V.

Auteurs

Walter S Marcantoni (WS)

CIUSSS du l'Ouest-de-l'Île-de-Montréal (Quebec), Canada; Concordia University (Quebec), Canada. Electronic address: walter.marcantoni.comtl@ssss.gouv.qc.ca.

Bertine Sandra Akoumba (BS)

CIUSSS du l'Ouest-de-l'Île-de-Montréal (Quebec), Canada.

Maggy Wassef (M)

CIUSSS du l'Ouest-de-l'Île-de-Montréal (Quebec), Canada.

Julie Mayrand (J)

CIUSSS du l'Ouest-de-l'Île-de-Montréal (Quebec), Canada.

Hinatea Lai (H)

CIUSSS du l'Ouest-de-l'Île-de-Montréal (Quebec), Canada.

Stéphane Richard-Devantoy (S)

McGill University (Quebec), Canada; Douglas Mental Health University Institute (Quebec), Canada.

Sylvie Beauchamp (S)

CIUSSS du l'Ouest-de-l'Île-de-Montréal (Quebec), Canada; McGill University (Quebec), Canada.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH