Intravenous ketamine for PTSD and treatment-resistant depression

WorkSafeBC Evidence-Based Practice Group, Martin CW
Record ID 32018002739
English
Authors' objectives: To explore whether low-dose intravenous ketamine is a viable treatment option for PTSD or treatment-resistant depression.
Authors' results and conclusions: Out of the 26 full text articles reviewed, only one study was selected and included in this report. The remaining 25 studies are summarized and added to the end of this report under Appendix-3. Low-dose intravenous ketamine remains an off-label, unstandardized and unregulated treatment for treatment-resistant depression (TRD) and PTSD. There is preliminary evidence for a rapid and transient antidepressant effect of low-dose IV ketamine in patients with TRD. As the effect of ketamine on depression results from complex interactions between numerous factors (e.g., dose, duration of the session, route and frequency of administration, health care setting) and as the currently available studies are small, display high heterogeneity and low quality, until definitive studies with larger study samples, in comparative and longitudinal formats are undertaken firm conclusions about the efficacy, effectiveness and safety of low-dose IV ketamine is not feasible. In the meantime, possible risks associated with long-term ketamine use (e.g., neurotoxicity, cystitis, dissociative side effects, cognitive effects, and abuse) should be strictly monitored.
Authors' methods: A systematic literature search was conducted on commercial medical literature databases on February 14, 2022. We used Boolean operators ?OR? and ?AND? during the keyword searches. The keywords were identified through our scoping review and PubMed searches, which also helped us finalize our inclusion and exclusion criteria as determined by our research question. The six databases included (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Health Technology Assessments, Ovid Medline, APA PsycInfo and CINAHL Complete) were searched from 2015 onwards, with limits on language (English only), and study design (systematic reviews, meta-analysis, randomized controlled trials).
Details
Project Status: Completed
Year Published: 2022
English language abstract: An English language summary is available
Publication Type: Mini HTA
Country: Canada
MeSH Terms
  • Depressive Disorder, Treatment-Resistant
  • Depressive Disorder, Major
  • Ketamine
  • Administration, Intravenous
  • Stress Disorders, Post-Traumatic
Keywords
  • ketamine
  • low dose
  • intravenous
  • major depressive disorder
  • post-traumatic stress disorder
Contact
Organisation Name: WorkSafeBC
Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698
Contact Name: ebpg@worksafebc.com
Contact Email: ebpg@worksafebc.com
Copyright: WorkSafe BC
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.