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Special Communication
April 2017

A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders

Author Affiliations
  • 1Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
  • 2Department of Psychiatry, Mayo Clinic, Rochester, Minnesota
  • 3Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia
  • 4Department of Psychiatry, Baylor College of Medicine, Houston, Texas
  • 5Department of Psychiatry, Michael E. Debakey Veterans Affairs Medical Center, Houston, Texas
  • 6Department of Psychiatry, Kaiser Permanente Northern California, San Francisco
  • 7Department of Psychiatry, Stanford University School of Medicine, Stanford, California
  • 8Department of Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts
  • 9Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida
JAMA Psychiatry. 2017;74(4):399-405. doi:10.1001/jamapsychiatry.2017.0080

Importance  Several studies now provide evidence of ketamine hydrochloride’s ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment. Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders.

Observations  This review and consensus statement provides a general overview of the data on the use of ketamine for the treatment of mood disorders and highlights the limitations of the existing knowledge. While ketamine may be beneficial to some patients with mood disorders, it is important to consider the limitations of the available data and the potential risk associated with the drug when considering the treatment option.

Conclusions and Relevance  The suggestions provided are intended to facilitate clinical decision making and encourage an evidence-based approach to using ketamine in the treatment of psychiatric disorders considering the limited information that is currently available. This article provides information on potentially important issues related to the off-label treatment approach that should be considered to help ensure patient safety.

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