Depressive DisordersMajor Depressive Disorder (MDD)Bipolar DisorderSuicidalityKetamine

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

This meta-analysis (s=41, of which five at 6-weeks post-treatment) found ketamine to be effective up to 6 weeks later when ketamine was used for the treatment of depressive episodes (MDD, bipolar). The effects found, at all three follow-up points, were large (g = -1.28 to -1.36).

Authors

  • Conley, A. A.
  • Norwood, A. E. Q.
  • Hatvany, T. C.

Published

Psychopharmacology
meta Study

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.

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

Introduction

Major depressive episodes produce severe, persistent symptoms that impair functioning across social, occupational and other domains and occur in both major depressive disorder (MDD) and bipolar I and II disorder. Standard treatments, including antidepressant medications and psychotherapies, are effective for many patients but often require weeks to months to yield clinical benefit. Because ketamine produces rapid reductions in depressive symptoms and suicidal ideation at subanaesthetic doses, it has attracted clinical and research interest as a potential short‑acting but rapid antidepressant. Conley and colleagues set out to evaluate whether ketamine's antidepressant effects extend beyond the short time windows typically considered in prior meta‑analyses. Specifically, the present meta‑analysis examined the efficacy of ketamine on depressive symptom severity at 2, 4 and 6 weeks after administration. By pooling randomized and open‑label human studies that measured depressive symptoms with the MADRS or HDRS, the study aimed to quantify effect sizes at these later time points and to examine moderators such as dose, treatment length and frequency, route and study design.

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Study Details

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