Depressive DisordersMajor Depressive Disorder (MDD)Treatment-Resistant Depression (TRD)Ketamine

Efficacy of ketamine in the rapid treatment of major depressive disorder: a meta-analysis of randomized, double-blind, placebo-controlled studies

This meta-analysis (2016, 9 RCT studies, n=368) suggests ketamine is an effective short-term treatment for major depressive disorder (MDD).

Authors

  • Han, Y.
  • Chen, J.
  • Zou, D.

Published

Neuropsychiatric Disease And Treatment
meta Study

Abstract

Background

An increasing number of studies are reporting that ketamine could be treated as a novel antidepressant for major depressive disorder (MDD). Therefore, we performed this meta-analysis to comprehensively and systematically assess the efficacy of ketamine for treating patients with MDD.

Method

Randomized, double-blind, placebo-controlled studies on ketamine versus placebo for treating MDD were searched up to April 2016 in medical databases (PubMed, CCTR, Web of Science, Embase, CBM-disc, and CNKI). Three treatment time points (24 and 72 h, and day 7) were chosen. Response and remission rates were the main outcomes. The random effects model was used. An intention-to-treat analysis was conducted.

Results

Nine high-quality studies that included 368 patients were selected to compare the efficacy of ketamine to placebo. The therapeutic effects of ketamine at 24 and 72 h, and day 7 were found to be significantly better than placebo. Response and remission rates in the ketamine group at 24 and 72 h, and day 7 were 52.2% and 20.6%; 47.9% and 23.8%; and 39.8% and 26.2%, respectively. No significant heterogeneity existed, and the Egger’s test showed no publication bias.

Conclusion

These results indicated that ketamine could yield a good efficacy in the rapid treatment of MDD. Future large-scale clinical studies are needed to confirm our results and investigate the mid- and long-term efficacy of ketamine in treating MDD.

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Research Summary of 'Efficacy of ketamine in the rapid treatment of major depressive disorder: a meta-analysis of randomized, double-blind, placebo-controlled studies'

Introduction

Major depressive disorder (MDD) is a common and disabling psychiatric condition for which many patients do not achieve remission with existing antidepressants; about 33% do not respond to available treatments. Ketamine, an N-methyl-d-aspartate (NMDA) receptor antagonist used as an anaesthetic, has attracted attention because several clinical studies and earlier reviews suggested it can produce a rapid antidepressant effect, including in treatment-resistant depression (TRD). A prior meta-analysis up to December 2013 included only four trials, and more randomized controlled trials (RCTs) have since been published. Han and colleagues therefore conducted an updated meta-analysis to synthesise randomized, double-blind, placebo-controlled trials comparing intravenous ketamine with placebo in adult patients with MDD, aiming to assess ketamine's rapid antidepressant efficacy. The review focused on response and remission at three early time points (24 hours, 72 hours, and day 7) to capture the acute effects of ketamine infusion.

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Study Details

References (7)

Papers cited by this study that are also in Blossom

The role of ketamine in treatment-resistant depression: a systematic review

Serafini, G., Howland, R. H., Rovedi, F. et al. · Current Neuropharmacology (2014)

Antidepressant effects of ketamine in depressed patients

Berman, R. M., Cappiello, A., Anand, A. et al. · Biological Psychiatry (2000)

Relationship of ketamine’s antidepressant and psychotomimetic effects in unipolar depression

Sos, P., Klirova, M., Novák, T. et al. · Neuropsychiatric Disease And Treatment (2013)

NMDAR inhibition-independent antidepressant actions of ketamine metabolites

Zanos, P., Moaddel, P. J., Morris, P. J. et al. · Nature (2016)

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