Is there a risk of addiction to ketamine during the treatment of depression? A systematic review of available literature

Summary & key facts

Researchers looked at all available studies to see whether ketamine given for depression leads to addiction. They reviewed 16 studies that together included about 2,200 adults with depression and used different ways of giving ketamine, like injections and a nasal spray. The big finding was that almost no one in these studies showed clear signs of tolerance or withdrawal. The authors say ketamine looks relatively safe when given by doctors with careful monitoring, but the studies are short and mixed in quality, so we still need longer and more specific studies to be sure about long-term addiction risk.

Key facts:

• The review combined 16 studies that included about 2,200 adults being treated for depression with repeated, low-dose ketamine.
• Researchers found only four people across all these studies who showed clear signs of tolerance to ketamine’s antidepressant effect or withdrawal symptoms after stopping it.
• Studies used many ways to give ketamine: intravenous (into a vein), intramuscular (into a muscle), intranasal (a nasal spray), oral swallowing, and under-the-tongue (sublingual).
• Most studies used the standard mix of ketamine’s two forms. A few used the S-only nasal spray called esketamine.
• Animal and some early human studies suggest the S-form of ketamine may have higher potential for misuse than the R-form, but animal results do not always apply to people.
• The authors emphasize that ketamine should be given under medical supervision with close monitoring and careful dosing to reduce potential harms.
• The review points out important limits: the included studies were different from each other, often short, and they did not use standard scales designed to measure drug dependence.
• Because of those limits, the authors call for longer studies that use specific, quantitative tools to measure tolerance, withdrawal, and other signs of dependence.

Abstract

Despite the heterogeneity in study designs and outcome assessment methods, the review underscores the relative safety of ketamine treatment for adult patients with depression, emphasising the importance of medically supervised administration, vigilant monitoring and judicious dosing. Future long-term studies employing quantitative scales to assess dependence phenomena could contribute to strengthening the evidence for the safe and effective use of ketamine in the treatment of depression.

Topics

Mental Health Research Topics Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Addiction Cognition Depression (economics) Dosing Economics Environmental health Intensive care medicine Internal medicine Ketamine Law Macroeconomics Major depressive disorder Medicine MEDLINE Pharmacology Political science Population Psychiatry PsycINFO Randomized controlled trial Systematic review Treatment-resistant depression

Substances

Ketamine

Conditions & symptoms

Addiction Depression Addiction or harmful habbits Sadness or low mood