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Ketamine as a mental health treatment : Are acute psychoactive effects associated with outcomes? A systematic review
Grabski, Meryem Borissova, Anna Marsh, Beth Morgan, Celia J. A. Curran, H. Valerie
Grabski, Meryem
Borissova, Anna
Marsh, Beth
Morgan, Celia J. A.
Curran, H. Valerie
Citations
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Author
Grabski, Meryem
Borissova, Anna
Marsh, Beth
Morgan, Celia J. A.
Curran, H. Valerie
Borissova, Anna
Marsh, Beth
Morgan, Celia J. A.
Curran, H. Valerie
Abstract
Esketamine was recently licensed by the US Food and Drug Administration (FDA) and European Drug Agency (EDA) for use in treatment resistant depression (TRD), and further research indicates ketamine as a possible treatment in other mental health conditions. While the underlying mechanisms remain unclear, it has been hypothesised that ketamine’s acute psychoactive effects may be associated with psychiatric treatment efficacy. We systematically reviewed the evidence for this association. The databases Medline, Embase and PsychInfo were searched up to June 2019. Studies were included if they enrolled adults with a psychiatric diagnosis, assessed acute psychoactive effects using a quantitative measure, and reported on the relationship between acute effects and treatment outcome. We included 21 studies, involving 891 patients. Seventeen studies assessed patients with depression (TRD [k = 14]), three assessed substance use disorders, and one assessed social anxiety disorder. Overall, 41 associations were assessed, of which 26 % were significant. The studies reviewed displayed great variability in terms of methodology and quality of reporting. The most commonly assessed effect was dissociation, measured by the CADSS. Our results suggest that the CADSS total is not consistently associated with antidepressant outcomes. Apart from this, the current literature is too limited to draw definite conclusions on the presence of an association between acute psychoactive effects and mental health outcomes. The field would benefit from consistently employing a priori hypotheses, more transparent reporting and sufficiently powered statistical analyses. Furthermore, the use of a broader range of assessments tools of acute psychoactive effects during ketamine administration would be beneficial.
Keywords
review, ketamine, mental health, psychotomimetic effects, dissociative effects, psychedelic effects, mystical experience
Date
2020
Type
Journal article
Journal
Behavioural Brain Research
Book
Volume
392
Issue
Page Range
1-10
Article Number
Article 112629
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled
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