Anxiety DisordersMajor Depressive Disorder (MDD)Depressive DisordersKetamine

A consensus statement on the use of ketamine in the treatment of mood disorders

This review (2017) investigates the potential and caution related to ketamine in the treatment of mood disorders.

Authors

  • Sanjay Mathew
  • Gerard Sanacora
  • Mark Andrew Frye

Published

JAMA Psychiatry
meta Study

Abstract

Importance

Several studies now provide evidence of ketamine hydrochloride’s ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment. Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders.Observations: This review and consensus statement provides a general overview of the data on the use of ketamine for the treatment of mood disorders and highlights the limitations of the existing knowledge. While ketamine may be beneficial to some patients with mood disorders, it is important to consider the limitations of the available data and the potential risk associated with the drug when considering the treatment option.

Conclusions and Relevance

The suggestions provided are intended to facilitate clinical decision making and encourage an evidence-based approach to using ketamine in the treatment of psychiatric disorders considering the limited information that is currently available. This article provides information on potentially important issues related to the off-label treatment approach that should be considered to help ensure patient safety.

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Research Summary of 'A consensus statement on the use of ketamine in the treatment of mood disorders'

Introduction

Sanacora and colleagues situate this consensus statement in the context of accumulating, mostly small studies reporting that ketamine hydrochloride can produce rapid and robust antidepressant effects in patients with treatment-resistant mood and anxiety disorders. Earlier randomized, placebo-controlled trials (seven such trials comprising 147 treated patients) and multiple case series have generated substantial clinical and public interest, but the authors note important uncertainties: small sample sizes, short durations of follow-up, limited safety data for psychiatric use, no US Food and Drug Administration approval for psychiatric indications, and no postmarketing surveillance for ketamine used in psychiatry. This report from the American Psychiatric Association Council of Research Task Force Subgroup on Treatment Recommendations for Clinical Use of Ketamine aims to provide an overview and expert clinical opinion about off-label ketamine use for mood disorders. It is intended to complement an existing APA meta-analysis and other reviews by highlighting critical issues clinicians should consider when contemplating ketamine treatment for major depressive episodes, rather than to serve as a formal guideline, policy, or standard of care.

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Study Details

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