title: [Ketamine in acute and severe major depressive disorder].
abstract: BACKGROUND
  Depression is a frequent, severe and expensive illness. Approximately 20% of depressive episodes are resistant to classic antidepressants. Glutamatergic antagonists, in particular ketamine, established a new, rapid and robust therapeutic approach in resistant depression.
  
  
  RESULTS
  The main results in the literature show a rapid and robust antidepressant effect of ketamine, with infra-anesthesic posology (0.5mg/kg) administered in intravenous way. Positive effects are observed on depressive symptoms, suicidal thoughts, and there is a potential synergic action when used in the induction of anesthesia for electroconvulsive therapy. However, effects only last shortly. Side effects are mostly reversible and of mild intensity, no severe consequences were reported.
  
  
  CONCLUSIONS
  Limits are the lack of power of the included studies, due to small sample sizes, and the scarcity of studies. Misuse of ketamine is an important issue to be taken into account, and few data about ketamine addiction potential and its long-term effects are published at the moment.
authors.affiliation: CHU de Montpellier, université Montpellier 1, service universitaire de psychiatrie, Inserm 1061, 34000 Montpellier, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Brittner
authors.affiliation: Hôpital Sainte-Marguerite, service hospitalo-universitaire de psychiatrie, 13009 Marseille, France.
authors.forename: Jean-Arthur
authors.initials: JA
authors.lastname: Micoulaud-Franchi
authors.affiliation: Hôpital Sainte-Marguerite, service hospitalo-universitaire de psychiatrie, 13009 Marseille, France.
authors.forename: Raphaelle
authors.initials: R
authors.lastname: Richieri
authors.affiliation: Faculté de médecine, laboratoire de santé publique, EA 3279, 13385 Marseille cedex 05, France.
authors.forename: L
authors.initials: L
authors.lastname: Boyer
authors.affiliation: Hôpital Sainte-Marguerite, service hospitalo-universitaire de psychiatrie, 13009 Marseille, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Adida
authors.affiliation: Hôpital Sainte-Marguerite, service hospitalo-universitaire de psychiatrie, 13009 Marseille, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Lancon
authors.affiliation: Groupe des hôpitaux universitaires de Mondor, université Paris-Est-Créteil, pôle de psychiatrie, Eq psychiatrie génétique, fondation FondaMental, fondation de coopération scientifique en santé mentale, DHU Pepsy, Inserm U955, 40, rue de Mesly, 94010 Créteil, France. Electronic address: guillaume.fond@gmail.com.
authors.forename: Guilllaume
authors.initials: G
authors.lastname: Fond
mesh_terms: D000208:Acute Disease; D002986:Clinical Trials as Topic; D003865:Major Depressive Disorder / Q000188:drug therapy*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D006801:Humans; D007649:Ketamine / Q000627:therapeutic use*; D012720:Severity of Illness Index
chemical_list: D018691:Excitatory Amino Acid Antagonists; D007649:Ketamine