Depressive DisordersMajor Depressive Disorder (MDD)Ketamine

An Update on the Efficacy and Tolerability of Oral Ketamine for Major Depression: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis of oral ketamine for major depression (10 studies; meta-analysis of three RCTs, N=161) found a significant antidepressant effect (SMD −0.75). The paper also summarises tolerability data but emphasises that the evidence base is small and further high-quality trials are needed.

2 cited-by links indexed in Blossom

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Authors

  • Mark Andrew Frye

Published

Psychopharmacology Bulletin
meta Study

Abstract

Background

Intravenous Ketamine has shown robust antidepressant efficacy although other routes of administration are currently needed. We conducted a systematic review and meta-analysis of studies evaluating the efficacy and tolerability of oral ketamine for depression.

Methods

A comprehensive search of major electronic databases from inception to April 2020 was performed. Studies of oral ketamine for depression, from case series to randomized clinical trials, were eligible. Randomized controlled trials were included in a meta-analysis, focusing on response, remission, time to effect, and side effects.

Results

A total of 917 articles were identified with 890 studies screened, yielding a total of 10 studies included in our systematic review.Three randomized controlled trials (RCTs) (N = 161, mean age 37.9 ± 9.5 years, 58.6% females) were included in the meta-analysis. Pooled analysis suggested a significant antidepressant effect of oral ketamine (SMD: −0.75; 95% CI: −1.08, −0.43; p

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Research Summary of 'An Update on the Efficacy and Tolerability of Oral Ketamine for Major Depression: A Systematic Review and Meta-Analysis'

Editorial

βBlossom's Take

This review is useful because oral ketamine is often discussed as a practical alternative to intravenous and intranasal routes, but the evidence has been scattered across small studies. By pooling the randomised data and keeping tolerability in view, it gives a clearer sense of what is known, what is still thin, and where route-of-administration questions remain open.

Oral ketamine showed a significant antidepressant effect in a small meta-analysis

Sourced

What does the pooled clinical evidence say about oral ketamine for major depression?

SMD −0.75
Pooled antidepressant effect
10 studies
Studies in the systematic review
3 RCTs
Randomised trials in the meta-analysis
N = 161
Total randomised participants
Evidence synthesis figure.

Systematic review and meta-analysis of oral ketamine for major depression, based on three randomised controlled trials within 10 included studies. The pooled result is clinical and not mechanistic, but the evidence base is small and the abstract excerpt provided does not give the full p value or the tolerability estimates.

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Study Details

Cited By (2)

Papers indexed in Blossom that reference this study.

Safety, effectiveness and tolerability of sublingual ketamine in depression and anxiety: A retrospective study of off-label, at-home use

Hassan, K., Struthers, W. M., Sankarabhotla, A. et al. · Frontiers in Psychiatry (2022)

23 cited
Use of ketamine and esketamine for depression: an overview of systematic reviews with meta-analyses

de Mendoça Lima, T., Visacri, M. B., Aguiar, P. M. · European Journal of Clinical Pharmacology (2021)

37 cited

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