The Effects of Ketamine and Esketamine on Measures of Quality of Life in Major Depressive Disorder and Treatment-Resistant Depression: A Systematic Review.

Ketamine and esketamine produce rapid antidepressant effects in major depressive disorder and treatment-resistant depression, but their impact on patient-reported quality of life has been unclear. A systematic review of five studies found that both agents improve quality of life measures on scales such as the WHOQOL-BREF, Assessment of Quality of Life 8D, and EuroQol-5 Dimension-5 Layers, with statistically significant results. However, the studies had an overall moderate risk of bias and varied in the quality-of-life scales used and study duration. Further research should examine effects on specific quality-of-life domains.

Study at a glance

Abstract

The rapid and clinically meaningful antidepressant effects of ketamine and esketamine are well-established in major depressive disorder (MDD) and treatment-resistant depression (TRD) as evidenced by improvement in clinician- and patient-reported depression measures. However, there remains a need to determine how these agents affect patient-reported quality of life (QoL). Herein, we aimed to systematically review extant studies evaluating the effect of ketamine and esketamine on QoL measures. A literature search was conducted on online databases (PubMed, Scopus, Web of Science, Medline, and clinicaltrials.gov) for articles from inception to September 30th, 2024, reporting on the association between ketamine/esketamine and measures of QoL in persons diagnosed with MDD or TRD. A risk of bias assessment was conducted using the ROBINS-1 tool and the Newcastle-Ottawa Scale. Five studies were identified that investigated the association between ketamine/esketamine and measures of QoL in persons with MDD or TRD. Scales used to measure QoL included the WHOQOL-BREF scale, Assessment of Quality of Life 8D test, and the EuroQol-5 Dimension-5 Layers. Statistically significant findings (p < 0.001) suggest that ketamine and esketamine improve measures of QoL in persons with MDD or TRD. However, an overall moderate risk of bias was observed in the papers included in this analysis. Extant studies suggest that ketamine and esketamine treatment are associated with improvement in QoL measures in adults with MDD or TRD. Limitations of this study include hetergeneity in the types of QoL scales as well as study study duration among the studies included. Near-term research priorities should endeavour to investigate the effect of ketamine and esketamine on specific domains of QoL, respectively.