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Ketamine for unipolar depression: A systematic review of efficacy and safety.

Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
April 16, 2025
Tharshanan Edwin Peiris et al. (3 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the efficacy and safety of ketamine as a rapid-acting antidepressant for treatment-resistant unipolar depression.

Results Summary

Ketamine significantly reduced depressive symptoms and suicidal ideation within hours, with effects lasting up to 1 week, but common side effects included transient dissociation, elevated blood pressure, nausea, and dizziness. Long-term safety remains uncertain.

Population

Individuals with formally diagnosed unipolar depression, particularly treatment-resistant cases.

Effective Dosage

Not specified in the abstract.

Duration

Effects observed within hours, lasting up to 1 week (intervention duration not specified).

Interactions

None mentioned.

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
ketamine
decrease
depressive symptoms
formally diagnosed individuals
-
significantly reduced
#1
ketamine
decrease
suicidal ideation
formally diagnosed individuals
-
significantly reduced
#2
ketamine
decrease
depressive symptoms
formally diagnosed individuals
1 week
effects lasting up to
#3
ketamine
increase
transient dissociation
formally diagnosed individuals
-
common side effects included
#4
ketamine
increase
elevated blood pressure
formally diagnosed individuals
-
common side effects included
#5
ketamine
increase
nausea
formally diagnosed individuals
-
common side effects included
#6
ketamine
increase
dizziness
formally diagnosed individuals
-
common side effects included
#7
Abstract

BackgroundUnipolar depression is a prevalent mental health disorder with persistent, treatment-resistant symptoms. Traditional antidepressants take weeks to show effects, underscoring the need for faster alternatives. Ketamine, originally an anaesthetic, has emerged as a rapid-acting antidepressant.ObjectiveThis systematic review evaluates ketamine's efficacy and safety in unipolar depression.MethodsA literature search (January 2000-May 2024) in PubMed, PsycINFO, and Cochrane Library included RCTs, CCTs, systematic reviews, meta-analyses, and observational studies on ketamine or esketamine in formally diagnosed individuals. Study characteristics, interventions, outcomes, and adverse events were analyzed, with quality and bias assessments.ResultsAcross 44 studies, ketamine significantly reduced depressive symptoms and suicidal ideation within hours, particularly in treatment-resistant cases, with effects lasting up to 1 week. Common side effects included transient dissociation, elevated blood pressure, nausea, and dizziness, while long-term safety remains uncertain.ConclusionsKetamine shows promise as a rapid antidepressant for treatment-resistant unipolar depression. However, long-term safety and optimal treatment protocols require further research. Careful clinical integration with monitoring is recommended.

Study Links
Quality Scores
Safety65
Efficacy85/10
Quality80/10
Research Impact Scores
APT Score0.05
Weight Score2.60
Normalized Score0.76
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