Ketamine is an N-methyl-d-Aspartate receptor agonist with well-established safety and efficacy as an analgesic and anesthetic. Since it was developed in 1964, largely as a replacement for phencyclidine, it has been used primarily in veterinary and pediatric anesthesia, but in recent years it has also been used in psychiatry after reports of its rapid-acting antidepressant effects.
In the past 2 decades, ketamine has been used for the treatment of a broad range of mental health conditions beyond depression.
A systematic review published in the British Journal of Psychiatry Open evaluated multiple human studies, investigating the therapeutic effects of ketamine in the treatment of mental health disorders.
The study uncovers the unique potential for ketamine as a treatment for other mental health issues than solely depression, including suicidal thoughts. The data included suggest that ketamine is an effective treatment for depression and bipolar disorder and that it can reduce suicidal thoughts to a significant degree in some people, independent of its antidepressant effects.
The researchers also found that ketamine can lead to short-term reductions in cravings and withdrawal symptoms in individuals with substance use disorders.
They found that symptoms associated with depression and bipolar disorder can be reduced with ketamine as quickly as one to four hours after a single dose and that the reductions lasted up to 2 weeks. Also, a drop in suicidality was seen four hours after the treatment and lasted up to a week.
Only a small number of trials provided evidence to support the beneficial effects of ketamine for post-traumatic stress disorder and obsessive-compulsive disorder.
The researchers believe that the results are important because when people come to emergency rooms following suicide attempts the healthcare workers don’t know what their diagnosis is, so a drug that works across different mental health problems could be really useful.
Walsh, Z., Mollaahmetoglu, O., Rootman, J., Golsof, S., Keeler, J., Marsh, B., . . . Morgan, C. (2022). Ketamine for the treatment of mental health and substance use disorders: Comprehensive systematic review. BJPsych Open, 8(1), E19. doi:10.1192/bjo.2021.1061