Ketamine administration in depressive disorders: A systematic review and meta-analysis
Psychopharmacology. 2014-07-20; 231(18): 3663-3676
DOI: 10.1007/s00213-014-3664-5
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1. Psychopharmacology (Berl). 2014 Sep;231(18):3663-76. doi:
10.1007/s00213-014-3664-5. Epub 2014 Jul 20.
Ketamine administration in depressive disorders: a systematic review and
meta-analysis.
Fond G(1), Loundou A, Rabu C, Macgregor A, Lançon C, Brittner M,
Micoulaud-Franchi JA, Richieri R, Courtet P, Abbar M, Roger M, Leboyer M, Boyer
L.
Author information:
(1)Pôle de psychiatrie des hôpitaux universitaires H Mondor, Université Paris
Est-Créteil, INSERM U955, Eq Psychiatrie Génétique, Fondation FondaMental
Fondation de coopération scientifique en santé mentale, 40, rue de Mesly, 94010,
Créteil, France, .
Comment in
Psychopharmacology (Berl). 2014 Oct;231(19):3907-8.
INTRODUCTION: Ketamine’s efficacy in depressive disorders has been established in
several controlled trials. The aim of the present study was to determine whether
or not ketamine administration significantly improves depressive symptomatology
in depression and more specifically in major depressive disorder (MDD), bipolar
depression, resistant depression (non-ECT studies), and as an anesthetic agent in
electroconvulsive therapy (ECT) for resistant depression (ECT studies). Secondary
outcomes were the duration of ketamine’s effect, the efficacy on suicidal
ideations, the existence of a dose effect, and the safety/tolerance of the
treatment.
METHODS: Studies were included if they met the following criteria (without any
language or date restriction): design: randomized controlled trials,
intervention: ketamine administration, participants: diagnosis of depression, and
evaluation of severity based on a validated scale. We calculated standardized
mean differences (SMDs) with 95 % confidence intervals (CIs) for each study. We
used fixed and random effects models. Heterogeneity was assessed using the I2
statistic.
RESULTS: We included nine non-ECT studies in our quantitative analysis (192
patients with major depressive disorder and 34 patients with bipolar depression).
Overall, depression scores were significantly decreased in the ketamine groups
compared to those in the control groups (SMD = -0.99; 95 % CI -1.23, -0.75;
p