Efficacy and safety of ketamine for the treatment of depressive symptoms in palliative care: A systematic review.
Braz J Psychiatry
; 45(2): 182-195, 2023 May 11.
Article
en En
| MEDLINE
| ID: mdl-36574497
ABSTRACT
OBJECTIVES:
Ketamine has a fast onset of action that may offer a paradigm change for depression management at the end of life. We aimed to synthesize evidence regarding the safety and efficacy of ketamine in depression treatment within a broad palliative care concept.METHODS:
We searched seven databases and included studies on the safety and efficacy of ketamine for depression treatment in patients diagnosed with any life-threatening disease. We also conducted a narrative review of the evidence.RESULTS:
Among 2,252 screened titles and abstracts, we included 32 studies in our finalsynthesis:
14 case reports, two case series, two quasi-experimental studies, and seven randomized clinical trials (RCTs), as well as data from three unpublished clinical trials and seven cases from four larger case series. Most case reports reported a robust effect; however, the larger studies reported conflicting findings. Five RCTs reported positive outcomes; however, four of them were focused on a perioperative setting. Two negative studies did not primarily focus on depression and did not apply severity cutoffs.CONCLUSIONS:
Although ketamine is generally safe and potentially useful, its efficacy in palliative care settings remains unclear. It may be a reasonable alternative for perioperative depression in oncological patients.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Ketamina
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Año:
2023
Tipo del documento:
Article