TY - JOUR
T1 - The time course of psychotic symptom side effects of ketamine in the treatment of depressive disorders
T2 - a systematic review and meta-analysis
AU - Tashakkori, Maryam
AU - Ford, Andrew
AU - Dragovic, Milan
AU - Gabriel, Laura
AU - Waters, Flavie
PY - 2021/2
Y1 - 2021/2
N2 - Objective: Ketamine is a potential rapid-acting treatment for depression. Studies have suggested that the side effects are minimal and temporary, but the psychotic symptom side effects have yet to be fully examined. This study investigated whether ketamine infusion in the treatment of mood disorders is associated with increases in positive symptoms and whether these symptom effects endure over time. Methods: A systematic review and meta-analysis of studies of ketamine in the treatment of depression. Embase and Medline databases were searched for studies including (a) participants with major affective disorders, (b) 0.4 or 0.5 mg intravenously administered ketamine, (c) measurement of positive symptoms using BPRS+, and (d) a within-subject repeated-measures design with participants serving as their own baseline. Results: Seventeen studies met the inclusion criteria, comprising 458 participants. The meta-analyses examined symptom change occurring within the first 4 h, after 1 day, and after 3 days. Results showed significant BPRS+ increases within the first 30–60 min in 72% of studies, followed by a return to baseline levels. Conclusion: Peak symptom change occurred within the first hour post infusion. There are limited data to determine if ketamine is safe in the longer term, but there were no indications that psychotic symptoms re-occurred after the first hour and in the days following administration.
AB - Objective: Ketamine is a potential rapid-acting treatment for depression. Studies have suggested that the side effects are minimal and temporary, but the psychotic symptom side effects have yet to be fully examined. This study investigated whether ketamine infusion in the treatment of mood disorders is associated with increases in positive symptoms and whether these symptom effects endure over time. Methods: A systematic review and meta-analysis of studies of ketamine in the treatment of depression. Embase and Medline databases were searched for studies including (a) participants with major affective disorders, (b) 0.4 or 0.5 mg intravenously administered ketamine, (c) measurement of positive symptoms using BPRS+, and (d) a within-subject repeated-measures design with participants serving as their own baseline. Results: Seventeen studies met the inclusion criteria, comprising 458 participants. The meta-analyses examined symptom change occurring within the first 4 h, after 1 day, and after 3 days. Results showed significant BPRS+ increases within the first 30–60 min in 72% of studies, followed by a return to baseline levels. Conclusion: Peak symptom change occurred within the first hour post infusion. There are limited data to determine if ketamine is safe in the longer term, but there were no indications that psychotic symptoms re-occurred after the first hour and in the days following administration.
KW - bipolar disorder
KW - depression
KW - hallucinations
KW - mania
KW - mood
KW - psychotic symptoms
UR - http://www.scopus.com/inward/record.url?scp=85095937329&partnerID=8YFLogxK
U2 - 10.1177/1039856220961642
DO - 10.1177/1039856220961642
M3 - Article
C2 - 33181029
AN - SCOPUS:85095937329
VL - 29
SP - 80
EP - 87
JO - Australasian Psychiatry: bulletin of The Royal Australian and New Zealand College of Psychiatrists
JF - Australasian Psychiatry: bulletin of The Royal Australian and New Zealand College of Psychiatrists
SN - 1039-8562
IS - 1
ER -