Side-effects associated with ketamine use in depression: a systematic review

Lancet Psychiatry. 2018 Jan;5(1):65-78. doi: 10.1016/S2215-0366(17)30272-9. Epub 2017 Jul 27.


This is the first systematic review of the safety of ketamine in the treatment of depression after single and repeated doses. We searched MEDLINE, PubMed, PsycINFO, and Cochrane Databases and identified 288 articles, 60 of which met the inclusion criteria. After acute dosing, psychiatric, psychotomimetic, cardiovascular, neurological, and other side-effects were more frequently reported after ketamine treatment than after placebo in patients with depresssion. Our findings suggest a selective reporting bias with limited assessment of long-term use and safety and after repeated dosing, despite these being reported in other patient groups exposed to ketamine (eg, those with chronic pain) and in recreational users. We recommend large-scale clinical trials that include multiple doses of ketamine and long-term follow up to assess the safety of long-term regular use.

Publication types

  • Systematic Review

MeSH terms

  • Anesthetics, Dissociative / administration & dosage
  • Anesthetics, Dissociative / adverse effects
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / adverse effects
  • Depressive Disorder, Treatment-Resistant / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Humans
  • Ketamine* / administration & dosage
  • Ketamine* / adverse effects
  • Long Term Adverse Effects / chemically induced
  • Long Term Adverse Effects / diagnosis
  • Long Term Adverse Effects / prevention & control
  • Treatment Outcome


  • Anesthetics, Dissociative
  • Antidepressive Agents
  • Ketamine