Ketamine as a novel treatment for major depressive disorder and bipolar depression: a systematic review and quantitative meta-analysis

Ketamine for Treatment-Resistant Unipolar and Bipolar Major Depression: Critical Review and Implications for Clinical Practice

“…3 (number needed to treat). A separate meta-analysis by Xu et al [41] also reported large effects favoring ketamine for short-term positive response (pooled response rate 50 vs. 13%, RR 2.6, 95% CI: 1.6-4.4 at 24 hrs; pooled response rate 31 vs. 7%, RR 3.4, 95% CI: 1.6-7.1 at 7 days), and remission (pooled remission rate 28 vs. 3%, RR 5.2, 95% CI: 2.1-12.9 at 24 hrs; pooled remission rates 24 vs. 6%, RR 2.6, 95% CI: 1.2-5.7 at 7 days) [42] Total (n = [43] Total (n = Xu et al 2015 [41] Total (n = Lee et al 2015 [44] Total (n = Romeo et al 2015 [45] Total (n = Coyle and Laws [46] Total (n = [47] Total (n = Fond et al 2014 [48] Total (n = Caddy et al 2014 [49] Total (n = The study sample in one reviewed study consisted of depressed patients presenting acutely to an emergency room with suicidal ideation.…”

“…Interestingly, the effect sizes for reduction of depressive symptoms were numerically greater at 24 hrs for patients with MDD than those with BP in some [43,46] but not all reports. [44,45,48] McGirr et al [43] reported a a Data for stratified analyses of the association between ketamine treatment and transient remission in persons with MDD were provided in only one study. [51] b No evidence of heterogeneity regarding either response or remission as discrete endpoints between MDD and BP subsamples at 24 hrs, 3 days, or 7 days.…”

Ketamine use in current clinical practice

“…The findings of one meta-analysis added to the existing evidence that support ketamine as a novel treatment option for depression, stating that ketamine has been shown to have a high response rate and rapid effect [87] . Several independent pilot studies demonstrate that after a single intravenous infusion of sub-anesthetic dosages of ketamine, its anti-depressant effects have an onset within hours and are sustained for an average of 4-7 d [88,89] .…”

La ketamina come antidepressivo ad azione rapida: controversia e implicazioni [translation of “Ketamine as a rapid antidepressant: the debate and implications” by Dr. Giacomo Galli and Dr. Serena Saraceni]

“…Infine, nessuno dei 12 trial è stato condotto in Asia, Africa o Sud America, impedendo di generalizzare i risultati in riferimento alle popolazioni non caucasiche. Le meta-analisi dimostrano un significativo effetto di elevazione del tono dell'umore poco dopo l'infusione di ketamina (Coyle 2015;Lee 2015). Questo dato non sorprende, dal momento che tutti i trial hanno mostrato risultati positivi e la meta-analisi di Lee et al (2015) non ha utilizzato il test della regressione di Egger e non ha indicato il valore di p nell'analisi del bias di pubblicazione.…”