Overview
Ketamine, including racemic ketamine and esketamine, demonstrates rapid antidepressant effects for various forms of depression 23. It is considered an effective and safe treatment option for individuals experiencing depression 2.Diagnosis
No specific diagnostic criteria for ketamine-induced mood disorder are provided in the abstracts. The abstracts focus on the use of ketamine for treating depression.Management
Racemic ketamine and esketamine are effective for depression, showing improved response and remission rates compared to placebo 24.
Ketamine treatment is associated with improved depression severity 23.
Electroconvulsive therapy (ECT) and ketamine (alone or in combination) are effective for severe depression, with ECT potentially showing superior efficacy 1.
Higher adverse reactions have been noted with ketamine + ECT, requiring further study 1.
Racemic ketamine may demonstrate greater overall response and remission rates compared to esketamine 4.Special Populations
No specific information on special populations (pregnancy, pediatrics, elderly, comorbidities) is available in the provided abstracts.Key Recommendations
Ketamine and esketamine are effective, safe, and acceptable treatments for individuals with depression 2. (Evidence: Strong)
Ketamine treatment is associated with improved depression severity acutely and post-acutely 3. (Evidence: Strong)
Electroconvulsive therapy (ECT) may be superior to ketamine and their combination for improving depressive severity, though individualized treatment selection is warranted 1. (Evidence: Strong)References
1 Liu Y, Yang J, Liu Y. Ketamine and electroconvulsive therapy for severe depression: A network meta-analysis of efficacy and safety. Journal of psychiatric research 2024. link
2 Bahji A, Zarate CA, Vazquez GH. Efficacy and safety of racemic ketamine and esketamine for depression: a systematic review and meta-analysis. Expert opinion on drug safety 2022. link
3 Price RB, Kissel N, Baumeister A, Rohac R, Woody ML, Ballard ED et al.. International pooled patient-level meta-analysis of ketamine infusion for depression: In search of clinical moderators. Molecular psychiatry 2022. link
4 Bahji A, Vazquez GH, Zarate CA. Comparative efficacy of racemic ketamine and esketamine for depression: A systematic review and meta-analysis. Journal of affective disorders 2021. link