title: Ketamine as a new treatment for depression: a review of its efficacy and adverse effects.
abstract: OBJECTIVE
  Narrative review of the literature on the efficacy and safety of subanaesthetic doses of ketamine for the treatment of depression.
  
  
  METHODS
  Medline and PubMed databases were searched up to October 2012 using appropriate keywords.
  
  
  RESULTS
  The studies consistently report substantial efficacy with high response and remission rates from 4 to 72 hours (averages 77% and 43%, respectively) from single doses, though not all patients respond to ketamine. Early relapse is common. While the usual procedure involves the administration of intravenous ketamine at a dose of 0.5 mg/kg over 40 minutes, some preliminary evidence suggests other dosing regimens and routes of administration may be useful or even better. Repeated doses and maintenance pharmacological treatments have been investigated in order to prolong the antidepressant effects, with only modest success.
  
  
  CONCLUSIONS
  Current research on the antidepressant effects of ketamine has consistently shown rapid and substantial improvement in mood in the majority of patients. However, these effects have often been found to be short-lived. Future research should focus on identifying predictors of response (e.g. clinical, genetic, pharmacokinetic, environmental), examining different dosing regimens and routes of administration, and strategies to maintain the antidepressant response.
authors: School of Psychiatry, University of New South Wales, Sydney, Australia.
authors: Natalie
authors: N
authors: Katalinic
authors: Rosalyn
authors: R
authors: Lai
authors: Andrew
authors: A
authors: Somogyi
authors: Philip B
authors: PB
authors: Mitchell
authors: Paul
authors: P
authors: Glue
authors: Colleen K
authors: CK
authors: Loo
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy*; D003866:Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D007649:Ketamine / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D007649:Ketamine
keywords: Adverse effects; antidepressive agents; depressive disorder; ketamine; treatment outcome