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

Summary & key facts

This article is a review and expert statement about using ketamine to treat mood disorders. It says several studies show ketamine can produce fast and strong antidepressant effects in people whose depression or anxiety did not get better with other treatments. But most studies were small, and we do not have good information about how long the benefit lasts or about long-term safety. The authors note that off-label use of ketamine has grown, and they give recommendations to help doctors make careful, evidence-based choices and to protect patient safety.

Key facts:

• The paper reviewed existing studies and reached a consensus to guide doctors about using ketamine for mood disorders.
• Several studies found that ketamine can produce rapid and robust antidepressant effects in people whose mood or anxiety problems did not respond to other treatments.
• Most of the studies so far have had relatively small numbers of participants.
• There is limited information about how long ketamine’s benefits last over weeks, months, or years.
• There is limited data on the long-term safety of ketamine when used for mood and psychiatric disorders.
• Because of the promising but limited evidence, ketamine is being used more often as an off-label treatment, meaning it is used in ways not officially approved.
• The authors provide suggestions meant to help clinicians make evidence-based decisions and to highlight safety issues that should be considered when using ketamine.

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 Anxiety or worry Sadness or low mood