Ketamine use in pediatric depression: A systematic review

This systematic review (n=46; s=6) examined the efficacy and safety of ketamine for the treatment of pediatric depression (mean age=15.7 y/o). Findings suggested that ketamine, administered intravenously at doses ranging from 35mg/70kg to 140–490mg/70kg, significantly reduced depressive symptoms without severe adverse events.

Abstract of Ketamine use in pediatric depression

“Pediatric depression is a common psychiatric disorder that is associated with significant morbidity and mortality. Ketamine is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist with demonstrated antidepressant effects in the adult population, however, the efficacy and safety of ketamine for the treatment of pediatric depression remains poorly understood. Electronic databases were searched from inception to June 2022 to identify relevant articles. Six articles involving 46 participants with a mean age of 15.7 years were included in this systematic review. Out of six articles, three were case reports, one was a randomized clinical trial (RCT) and two were open-label trials. All studies used 0.5 mg/kg intravenous ketamine except for one, which used 2–7 micrograms/kg. Ketamine was significantly associated with reduced depressive symptoms without severe adverse events. Taken together, the results of these studies demonstrated the potential role of ketamine for treating pediatric depression. Several important limitations were identified, most notably the small sample sizes of the component studies, and that all studies administered intravenous ketamine. Further studies with larger sample sizes and different administration modalities are needed to better determine the efficacy and safety of ketamine in pediatric depression.”

Authors: Shakila Meshkat, Joshua D. Rosenblat, Roger C. Ho, Taeho G. Rhee, Bing Cao, Felicia Ceban, Kevork Danayan, Noah Chisamore, Joshua D. Di Vincenzo & Roger S. McIntyre 

Summary of Ketamine use in pediatric depression