Table 2. Summary of findings from case reports.
| Author | n | Age (years) | Sex | Palliative care diagnosis | Intervention (dose, route, duration) | Results (depression) | Side effects | Comments and follow-up |
|---|---|---|---|---|---|---|---|---|
| Zanicotti33,42 | 1 | 36 | Female | Metastatic ovarian cancer | Repeated IM ketamine (weekly for 10 months, 1 mg/kg) | MADRS reduction from 24 at baseline to 7 at 1 h after the first injection (71% improvement) | Moderate but tolerable dissociative effects Improved tolerability over time and stable vital signs | Sustained remission (MADRS <10) for 10 months on ketamine and 8 more months after discontinuation |
| Rocha40 | 1 | 76 | Female | Alzheimer’s disease | Repeated SC ketamine (eight doses, 0.5-0.75 mg/kg) | CGI-S reduction from 7 at baseline to 1 after two doses (3 days) | Light somnolence during ketamine sessions, no other side effects | Sustained remission for six more doses and 1 month after discontinuation |
| Stefanczyk-Sapieha45 | 1 | 50 | Male | Hormone-refractory prostate cancer | Repeated IV ketamine (two doses, 10 days interval, 0.5 mg/kg) | BDI and HAMD-17 reduction from 25 and 30 at baseline to 11 and 15 at 6 h after the second dose (56% and 50% improvement) | A brief episode of visual hallucinations during the second dose | Effects wore off quickly |
| Rodríguez-Mayoral & Domínguez-Ocadio35 | 1 | 39 | Female | Cervical epidermoid carcinoma | Single dose of IV ketamine (0.5 mg/kg) | BEDS reduction from 18 at baseline to 5 on day 17 (72%) | No side effects | |
| Swiatek36 | 1 | 62 | Male | Liver failure | Repeated oral ketamine (nine daily doses, 0.25-0.5 mg/kg) | HADS-D reduction from 16 at baseline to 10 after 48 h (38% improvement) | No safety measures reported | Mood worsened due to aggravated clinical condition Treatment was discontinued to focus on comfort |
| Barbosa37 | 1 | 65 | Male | Undifferentiated metastatic abdominal tumor | Repeated SC ketamine (four doses, twice a week, 0.5-0.75 mg/kg) | MADRS reduction from 30 at baseline to 9 on day 7 (70% improvement) | Stable vital signs, intense dissociative symptoms without discomfort | Patient died on day 11 |
| CortiñaS-Saenz43 | 1 | 42 | Female | Breast cancer with bone metastasis | Repeated IV ketamine (a single dose followed by five daily doses, 0.3-0.5 mg/kg) | HAMD-17 reduction from 22 at baseline to 13 (41% improvement) 4 days after discontinuation | Mild nausea and confusion | |
| Sexton38 | 1 | 64 | Male | Metastatic anaplastic thyroid cancer | A single continuous IV ketamine infusion (2 weeks, 0.2 mg/kg/h) | PHQ-9 24 at baseline, not reported at follow-up Remission of suicidal ideation and significant qualitative improvement on day 5 | Two episodes of worsening pain during the infusion | Sustained improvement for 2 weeks until his death |
| Rajagukguk & Lee39 | 1 | Late 40s | Male | Jejunal adenocarcinoma | A single infusion of IV ketamine (0.5 mg/kg) | Self-assessment of depression decreased from 8/10 to 0/10 in 24 h Significant qualitative improvement | Drowsiness | Worsened after 5 days, refused treatment |
| Litvan41 | 1 | 74 | Female | Mixed dementia (Alzheimer’s + vascular) | 12 sessions of ECT with esketamine anesthesia | Remission of catatonic symptoms | No safety measures reported | |
| Irwin34 | 2 | 64 | Female | COPD, respiratory failure | Repeated oral ketamine (two doses, 30 days interval, 0.5 mg/kg) | HAM-D-17 and HADS-D reduction of 66 and 50% at day 15 | No side effects reported | No response to the second dose |
| 70 | Male | Metastatic prostate cancer | A single dose of oral ketamine (0.5 mg/kg) | HAMD-17 and HADS-D reduction of 57 and 45% on day 8 | No changes in scores for adverse effects and cognitive status | Physical deterioration on day 13, could not participate in the assessments | ||
| McNulty & Hahn44 | 1 | 44 | Male | Heart failure and COPD | A single SC ketamine injection (0.5 kg/kg) followed by daily oral ketamine (0.5 mg/kg) | Improvement in self-assessed depression from 8/10 to 0/10 in 60 min | No side effects | Sustained remission under oral ketamine for 2 months |
BDI = Beck Depression Inventory; BEDS = Brief Edinburgh Depression Scale; CGI = Clinical Global Impression; COPD = chronic obstructive pulmonary disease; ECT = electroconvulsive therapy; HADS = Hospital Anxiety and Depression Rating Scale; HAMD-17 = Hamilton Depression Rating Scale; IM = intramuscular; IV = intravenous; MADRS = Montgomery-Asberg Depression Rating Scale; PHQ-9 = Patient Health Questionnaire; SC = subcutaneous.