Oral ketamine for the treatment of pain and treatment-resistant depression
Open accessAbstract
Background: Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications. Aims: To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain. Method: Searches in PubMed with the terms ‘oral ketamine’, ‘depression’, ‘chronic pain’, ‘neuropathic pain’, ‘intravenous ketamine’, ‘intranasal ketamine’ and ‘subcutaneous ketamine’ yielded 88 articles. We reviewed all papers for information about dosing regimen, number of individuals who received ketamine, number of ketamine days per study, results and side-effects, as well as study quality. Results: Overall, the methodological strength of studies investigating the antidepressant effects of ketamine was considered low, regardless of the route of administration. The doses for depression were in the lower range compared with studies that investigated analgesic use. Studies on pain suggested that oral ketamine may be acceptable for treatment-resistant depression in terms of tolerability and side-effects. Conclusions: Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials.
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Studies indicate that ketamine dependence is not frequently observed in chronic pain patients and depressed patients who receive daily ketamine dosages.
“However, studies indicate that ketamine dependence is not frequently observed in either chronic pain patients and depressed patients who receive daily ketamine dosages (Blonk et al., 2010;Schoevers et al., 2016).”
From Psychedelics for the treatment of depression, anxiety, and existential distress in patients with a terminal illness: a systematic review (2022) · cites this paper as Schoevers et al., 2016
The Safety and abuse potential section says addiction or misuse were not described as side-effects in the pain studies, and the Discussion says such problems were not prominent in the reviewed depression and pain studies. The paper does not establish how frequently dependence occurred specifically among patients receiving daily doses; it also notes that few studies systematically examined longer-term consequences. Page numbers were not available in our copy. (LLM, conf=0.83)
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- Authors
- Schoevers, R. A., Chaves, T. V., Balukova, S. M., Rot, M. A. H., & Kortekaas, R.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Schoevers, Robert A.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-02
- Volume
- 208
- Issue
- 2
- Pages
- 108-113
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2252387690
- Cited by
- 81
- References
- 82
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 5 · 2023: 4 · 2022: 6 · 2021: 10 · 2020: 12 · 2019: 7 · 2018: 10 · 2017: 6 · 2016: 6
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Yale University
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Keywords
- oral ketamine, treatment-resistant depression, chronic pain, neuropathic pain, route of administration, adverse effects, tolerability, antidepressant effects, analgesic effect
- MeSH terms
- Administration, Oral, Analgesics, Antidepressive Agents, Humans, Ketamine, Pain Measurement, Psychiatric Status Rating Scales, Treatment Outcome, Chronic Pain, Depressive Disorder, Treatment-Resistant
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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