Use of ketamine and esketamine for depression: an overview of systematic reviews with meta-analyses.

Purpose: To summarize the evidence of efficacy and safety of the use of ketamine and esketamine for depression. Methods: A literature search was performed in Medline, the Cochrane Library, LILACS, and CRD until November 2020. We included systematic reviews with meta-analyses of randomized controlled...

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Publicado en:European Journal of Clinical Pharmacology Vol. 78; no. 3; pp. 311 - 339
Autores principales: Lima, Tácio de Mendonça, Visacri, Marília Berlofa, Aguiar, Patricia Melo
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Springer Nature Mar2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2022
      vid: 78
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-021-03216-8
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        atl: Use of ketamine and esketamine for depression: an overview of systematic reviews with meta-analyses.
      aug:
        au:
          Lima, Tácio de Mendonça
          Visacri, Marília Berlofa
          Aguiar, Patricia Melo
        affil: Department of Pharmaceutical Sciences, Federal Rural University of Rio de Janeiro, Seropédica, RJ, Brazil
      sug:
        subj:
          Ketamine Therapeutic Use
          Hallucinogens Therapeutic Use
          Depression Drug Therapy
          Patient Safety
          Drug Efficacy
          Human
          Systematic Review
          Meta Analysis
          Medline
          Cochrane Library
          Treatment Outcomes
          Disease Remission
          Adult
          PubMed
          Adult: 19-44 years
      ab: Purpose: To summarize the evidence of efficacy and safety of the use of ketamine and esketamine for depression. Methods: A literature search was performed in Medline, the Cochrane Library, LILACS, and CRD until November 2020. We included systematic reviews with meta-analyses of randomized controlled trials on the use of ketamine and esketamine in adult patients with depression. Two authors independently performed the study selection and data extraction. The AMSTAR-2 tool was used to appraise the quality of included reviews. Results: A total of 118 records were identified, and 11 studies fully met the eligibility criteria. Compared to control, ketamine improved the clinical response at 40 min to 1 week and clinical remission at 80 min to 72 h, and esketamine improved both outcomes at 2 h to 4 weeks. Ketamine and esketamine also had a beneficial effect on the depression scales score and suicidality. For adverse events, oral ketamine did not show significant change compared to control, while intranasal esketamine showed difference for any events, such as dissociation, dizziness, hypoesthesia, and vertigo. Most reviews were classified as "critically low quality," and none of them declared the source of funding of the primary studies and assessed the potential impact of risk of bias in primary studies. Conclusion: Ketamine and esketamine showed a significant antidepressant action within a few hours or days after administration; however, the long-term efficacy and safety are lacking. In addition, the methodological quality of the reviews was usually critically low, which may indicate the need for higher quality evidence in relation to the theme.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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