Is there a risk of addiction to ketamine during the treatment of depression? A systematic review of available literature

Summary & key facts

This systematic review looked at 16 studies of ketamine used to treat adults with depression, covering 2,174 patients. The authors found few clear cases of tolerance or dependence (four patients) and conclude that, overall, ketamine appears relatively safe for depression when given under medical supervision, with careful monitoring and dosing. The review also notes big differences between studies and says more long-term research using standard measures of dependence is needed.

Key facts:

• The review included 16 studies and a total of 2,174 patients treated for depression.
• Study types were varied: 6 randomised controlled trials, 3 single-arm open-label studies, 1 retrospective study, 3 case series and 3 case reports.
• Different routes of ketamine were used across studies: intravenous, intramuscular, intranasal, oral and sublingual.
• Most studies used racemic ketamine; the intranasal studies used esketamine.
• Four patients across the included studies showed clear signs of tolerance to ketamine’s antidepressant effect or dependence on the drug, while the majority of patients did not show these signs.
• The authors highlight substantial heterogeneity in study designs and outcome measures, which limits how confidently results can be generalized.
• The review recommends medically supervised administration, vigilant monitoring, and careful dosing, and calls for future long-term studies using quantitative scales to assess dependence.

Abstract

Despite the heterogeneity in study designs and outcome assessment methods, the review underscores the relative safety of ketamine treatment for adult patients with depression, emphasising the importance of medically supervised administration, vigilant monitoring and judicious dosing. Future long-ter …

Topics

Mental Health Research Topics Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Addiction Cognition Depression (economics) Dosing Economics Environmental health Intensive care medicine Internal medicine Ketamine Law Macroeconomics Major depressive disorder Medicine MEDLINE Pharmacology Political science Population Psychiatry PsycINFO Randomized controlled trial Systematic review Treatment-resistant depression

Substances

Ketamine

Conditions & symptoms

Addiction Depression Addiction or harmful habbits