New Detailed Review of Oral Ketamine for Depression Published in JCP

Memphis, TN (April 16, 2019) – A review article published today in The Journal of Clinical Psychiatry indicates that orally administered ketamine is efficacious for depression but may take longer to yield results. The review, authored by Joshua D. Rosenblat and colleagues at the University of Toronto, analyzed 13 articles, including 2 randomized controlled trials (RCTs).

The RCTs demonstrated antidepressant efficacy and good tolerability for oral ketamine, but significant changes in depressive symptom severity were observed only after 2–6 weeks of treatment. This lag time is in contrast to the rapid effects of intravenous ketamine, which has been investigated for its antidepressant and antisuicidal effects over the past 2 decades.

Ketamine is an anesthetic agent that works differently from currently available antidepressants. Intranasal esketamine, approved by the FDA in March for treatment-resistant depression, and oral ketamine represent alternatives to intravenous ketamine, which can present challenges in terms of accessibility.

Due to risks of sedation and dissociative effects, as well as possible misuse, the FDA approval of intranasal esketamine requires that the drug be administered in a medical office where the patient can be monitored for 2 hours afterward. Rosenblat and colleagues note that, intriguingly, dissociative effects, often reported with IV ketamine, were rarely observed in the studies of oral ketamine. However, they caution that oral ketamine might lend itself to take-home doses that could be diverted or misused without adequate precautions. Given these concerns, along with insufficient current evidence, they emphasize that prescribing oral ketamine for depression cannot be recommended until further evidence is available.

Access the entire article, “Oral Ketamine for Depression: A Systematic Review,” by Joshua D. Rosenblat, MD; Andre F. Carvalho, MD, PhD; Madeline Li, MD, PhD; Yena Lee, BSc; Mehala Subramanieapillai, MSc; and Roger S. McIntyre, MD, at https://doi.org/10.4088/JCP.18r12475.

The Journal of Clinical Psychiatry, a peer-reviewed publication that is indexed and abstracted by the National Library of Medicine’s PubMed, is the official publication of the American Society of Clinical Psychopharmacology and is among the top 10 most cited psychiatry journals worldwide.

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This release was published on openPR.