A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders

Summary & key facts

A group of experts reviewed studies about using ketamine to treat mood and anxiety problems. The studies show ketamine can lift mood quickly for some people whose depression or anxiety did not get better with other treatments. But the studies were small, did not follow people for long, and gave only limited information about safety. Because of that uncertainty, the experts say doctors should be careful, follow evidence-based steps, and think about risks before using ketamine in ways that are not officially approved.

Key facts:

• Several studies found that ketamine can cause a fast and strong antidepressant effect in people whose mood or anxiety problems did not improve with other treatments.
• Those studies were mostly small and did not track people for a long time, so we do not know how well ketamine works over months or years.
• There is limited information about safety from the existing studies, so possible risks are not well measured.
• Use of ketamine as an off-label treatment (meaning used in ways not officially approved) has increased even though long-term benefits and risks are unclear.
• The experts wrote suggestions to help doctors make decisions and to encourage using the best available evidence to protect patient safety.

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.

Topics

Attention Deficit Hyperactivity Disorder Electroconvulsive Therapy Studies Treatment of Major Depression

Categories

Health Sciences Medicine Pharmacology

Tags

Anxiety Clinical psychology Ketamine Law Medicine MEDLINE Mood Mood disorders Political science Psychiatry Psychology

Substances

Ketamine

Conditions & symptoms

Anxiety Depression Anxiety or worry Sadness or low mood