Transforming treatment-resistant depression care in Norway: Public health reimbursement for off-label intravenous ketamine

Summary & key facts

This Norwegian health technology assessment looked at using intravenous ketamine for people whose depression did not get better with usual treatments. The authors reviewed clinical studies, costs, and patient views. They found that one ketamine infusion often reduces depressive symptoms fast, but the effect usually fades after days or weeks. Repeated infusions can extend the benefit for some people, but the evidence is limited and uncertain. Short-term side effects like feeling disconnected (dissociation) and higher blood pressure are common. The report says more research is needed about long-term benefits, safety, and how to organize treatment in the health system.

Key facts:

• The report reviewed clinical trials, economic analyses, and patient reports to judge if intravenous ketamine helps people with treatment-resistant depression.
• A single intravenous ketamine infusion often produced a quick drop in depression symptoms compared with saline (placebo), but the improvement usually lasted only days to a few weeks.
• Some studies of repeated ketamine infusions showed longer symptom relief for some people, but results were mixed and the overall certainty of the evidence was low.
• Common short-term side effects included dissociation (a feeling of being unreal or disconnected) and temporary rises in blood pressure.
• The report found that there is little reliable evidence about long-term benefits, relapse rates, or harms after repeated or long-term ketamine use.
• The health-economic part concluded that costs and budget impact depend a lot on how many people get treated and how services are set up, so the financial picture is uncertain.
• Patients described feeling relief and hope from ketamine treatment, but also worry about the short duration of effects and access to safe, coordinated care.
• The authors highlighted the need for more high-quality studies, clear clinical routines, and monitoring to reduce risks like potential misuse.

Topics

Attention Deficit Hyperactivity Disorder Pharmaceutical studies and practices Treatment of Major Depression

Categories

Health Sciences Medicine Pharmacology

Tags

Depression (economics) Disease Emergency medicine Health care Health economics Intensive care medicine Ketamine Medical emergency Medicine MEDLINE Patient care Psychiatry Public health Public health care Reimbursement

Substances

Ketamine

Conditions & symptoms

Depression Lack of energy or motivation Poor sleep Sadness or low mood