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Intravenous Ketamine for Adults with Treatment-Resistant Depression or Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines

Last updated: October 24, 2019
Project Number: RC1203-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of intravenous ketamine for adults with treatment-resistant depression or post-traumatic stress disorder?
  2. What is cost-effectiveness of intravenous ketamine for adults with treatment-resistant depression or post-traumatic stress disorder?
  3. What are the evidence-based guidelines regarding the use and administration of intravenous ketamine for adults with treatment-resistant depression or post-traumatic stress disorder?

Key Message

Three randomized controlled trials reported that intravenous ketamine was significantly more effective than placebo or midazolam for the treatment of adults with treatment-resistant depression. One randomized controlled trial reported no significant difference between intravenous ketamine (six repeated doses of 0.5mg/kg) and placebo. One evidence-based guideline reported a strong recommendation against treating post-traumatic stress disorder with ketamine monotherapy. No relevant evidence regarding the clinical effectiveness of intravenous ketamine for the treatment of post-traumatic stress disorder or the cost-effectiveness of intravenous ketamine for treatment-resistant depression or post-traumatic stress disorder was identified.