Efficacy of ketamine for major depressive episodes at 2, 4, and 6-weeks post-treatment: A meta-analysis

Psychopharmacology (Berl). 2021 Jul;238(7):1737-1752. doi: 10.1007/s00213-021-05825-8. Epub 2021 Mar 31.

Abstract

Rationale: Major depressive episodes are severe mood episodes which occur both in major depressive disorder and bipolar I and II disorder. Major depressive episodes are characterized by debilitating symptoms that often persist and interfere with typical daily functioning. Various treatments exist for major depressive episodes; however, most primary pharmacologic treatments may take weeks to months to provide relief from depressive symptoms. Ketamine is a demonstrated treatment for major depressive episodes, as relief from depressive symptoms can occur rapidly following treatment.

Objectives: Prior meta-analyses have been conducted to analyze the effectiveness of ketamine for the treatment of major depressive episodes, but at the time of this writing, no meta-analysis had been conducted to observe ketamine treatment efficacy beyond 2 weeks.

Methods: The present meta-analysis evaluated the efficacy of ketamine for the treatment of major depressive episodes; observations of depressive episode severity were analyzed at 2, 4, and 6-weeks post-treatment.

Results: The present meta-analysis observed large effects at 2 weeks (g = -1.28), 4 weeks, (g = -1.28), and 6 weeks (g = -1.36) post-treatment.

Conclusions: The results from the present meta-analysis indicate that ketamine can be an effective pharmacologic intervention for major depressive episodes, with treatment effects lasting up to 6 weeks post-ketamine administration, which has many positive implications for treatment.

Keywords: Bipolar; Depression; Ketamine; MDD; Major depressive episodes.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Affect / drug effects
  • Affect / physiology
  • Clinical Trials as Topic / methods*
  • Excitatory Amino Acid Antagonists / pharmacology
  • Excitatory Amino Acid Antagonists / therapeutic use*
  • Humans
  • Ketamine / pharmacology
  • Ketamine / therapeutic use*
  • Major Depressive Disorder / diagnosis
  • Major Depressive Disorder / drug therapy*
  • Major Depressive Disorder / psychology*
  • Time Factors
  • Treatment Outcome

Substances

  • Excitatory Amino Acid Antagonists
  • Ketamine