Efficacy and safety of ketamine for the treatment of depressive symptoms in palliative care: a systematic review
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
; Braz. J. Psychiatry (São Paulo, 1999, Impr.);45(2): 182-195, Mar.-Apr. 2023. tab, graf
Article
em En
|
LILACS-Express
| LILACS
| ID: biblio-1439558
Biblioteca responsável:
BR1.1
ABSTRACT
Objectives:
Ketamine has a fast onset of action that may offer a paradigm change for depression management at the end of life. We aimed to synthesize evidence regarding the safety and efficacy of ketamine in depression treatment within a broad palliative care concept.Methods:
We searched seven databases and included studies on the safety and efficacy of ketamine for depression treatment in patients diagnosed with any life-threatening disease. We also conducted a narrative review of the evidence.Results:
Among 2,252 screened titles and abstracts, we included 32 studies in our finalsynthesis:
14 case reports, two case series, two quasi-experimental studies, and seven randomized clinical trials (RCTs), as well as data from three unpublished clinical trials and seven cases from four larger case series. Most case reports reported a robust effect; however, the larger studies reported conflicting findings. Five RCTs reported positive outcomes; however, four of them were focused on a perioperative setting. Two negative studies did not primarily focus on depression and did not apply severity cutoffs.Conclusion:
Although ketamine is generally safe and potentially useful, its efficacy in palliative care settings remains unclear. It may be a reasonable alternative for perioperative depression in oncological patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Systematic_reviews
Idioma:
En
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Assunto da revista:
PSIQUIATRIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Brasil