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A systematic review of ketamine for the treatment of depression among older adults

Published online by Cambridge University Press:  30 June 2020

Aarti Gupta ,
Romika Dhar ,
Palak Patadia ,
Melissa Funaro ,
Gargi Bhattacharya ,
Syeda A. Farheen  and
Rajesh R. Tampi
Aarti Gupta
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
Romika Dhar
Affiliation:
Department of Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
Palak Patadia
Affiliation:
Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA
Melissa Funaro
Affiliation:
Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA
Gargi Bhattacharya
Affiliation:
Purdue University, West Lafayette, IN, USA
Syeda A. Farheen
Affiliation:
Department of Psychiatry, Case Western Reserve University MetroHealth Program, Cleveland, OH, USA
Rajesh R. Tampi*
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA Department of Psychiatry and Behavioral Sciences, Cleveland Clinic Akron General, Akron, OH, USA Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
*
Correspondence should be addressed to: Rajesh R. Tampi, Cleveland Clinic Akron General, 1 Akron General Avenue, Akron, Ohio, 44307, USA. Phone: (203) 809-5223, Fax: (330)-344-2943. Email: [email protected].
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Abstract

Objective:

To review the currently available data on the use of ketamine in the treatment of depression among older adults from randomized controlled studies.

Design:

Randomized controlled trials.

Setting:

Variable.

Participants:

60 years and older with depression.

Intervention:

Ketamine.

Measurements:

Change in Montgomery–Asberg Depression Rating Scale (MADRS) scores.

Results:

Two studies met the inclusion criteria. The first study showed a significant reduction in depression symptoms with use of repeated subcutaneous ketamine administration among older adults with depression. The second study failed to achieve significance on its primary outcome measure but did show a decrease in MADRS scores with intranasal ketamine along with a higher response and remission rates in esketamine group compared with the placebo group. The adverse effects from ketamine generally lasted only a few hours and abated spontaneously. No cognitive adverse effects were noted in either trial from the use of ketamine.

Conclusions:

The current evidence for use of ketamine among older adults with depression indicates some benefits with one positive and one negative trial. Although one of the trials did not achieve significance on the primary outcome measure, it still showed benefit of ketamine in reducing depressive symptoms. Ketamine was well tolerated in both studies with adverse effects being mild and transient.

Keywords

ketamineolder adultsmajor depressive disordertreatment-resistant depressionbipolar depression
Type
Review Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 2: Issue Theme: Schizophrenia and Depression in Older Adults , February 2021 , pp. 179 - 191
Copyright
© International Psychogeriatric Association 2020

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