Harvard Review of Psychiatry
March 1, 2022
Igor D. Bandeira, Daniel H. Lins-Silva, Vitor Breseghello Cavenaghi et al.
35 citations
Ketamine shows potential for fast onset of action and good tolerability in treating obsessive-compulsive disorder (OCD), but results have been erratic. The systematic review included nine articles: three randomized controlled trials, three case reports, two open-label trials, and one retrospective chart review. Most studies used only single-session racemic ketamine administered intravenously. No evidence demonstrates whether racemic ketamine, S-ketamine, or R-ketamine has the best efficacy, and only sparse evidence suggests combining ketamine with psychotherapy could benefit patients. Future randomized, double-blind, placebo-controlled trials with larger samples, multiple sessions, and appropriate washout periods are needed.
Psychiatry research
June 1, 2025
Flávia Vieira, Ana Teresa Caliman-Fontes, Breno Souza-Marques et al.
A systematic review of 46 studies on ketamine and its enantiomers for major depressive disorder identified 16 assessment tools used to measure suicidal behavior. Most were explicit, clinician-rated scales such as the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HAM-D), and Beck Scales for Suicide Ideation. Only the Suicide Ideation and Behavior Assessment Tool (SIBAT) was specifically developed for rapid-acting antidepressant trials. The variety of instruments used across studies makes comparisons difficult. The MADRS is suggested as a reasonable choice for assessing suicidal behavior in this context, though no single tool is universally preferable.
Journal of psychiatric research
August 1, 2023
Igor D Bandeira, Gustavo C Leal, Fernanda S Correia-Melo et al.
In a pilot trial of six people with bipolar I or II disorder who had been depressed for at least four weeks, two intravenous infusions of arketamine (0.5 mg/kg followed one week later by 1 mg/kg) rapidly reduced depression severity. Depression scores on the Montgomery-Åsberg Depression Rating Scale fell from a baseline mean of 36.66 to 27.83 one day after the first infusion and from 32.0 to 17.66 one day after the second infusion. The drug was well tolerated with almost no dissociation and no manic symptoms. The findings suggest arketamine has rapid-acting antidepressant properties for bipolar depression, consistent with earlier animal research on major depression.
Journal of affective disorders
June 1, 2023
Gustavo C Leal, Breno Souza-Marques, Rodrigo P Mello et al.
In a small pilot trial, the antidepressant arketamine was compared with placebo for treatment-resistant depression. Ten participants received both arketamine (0.5 mg/kg) and saline one week apart in a randomized, double-blind, crossover design. Depression improved over time, but there was no significant difference between arketamine and placebo. Dissociation and other adverse events were minimal. The study was underpowered, and the authors conclude that arketamine was not superior to placebo but was extremely safe, recommending larger trials with different dosing strategies.