Table 1.
Synthesis of Cochrane review and meta-analyses which have included RCT studies in their analyses, concerning ketamine efficacy
| Authors | Etiology | Review type [articles included] | n studies (n K studies) | n subjects (n K subjects) | Design | Ketamine efficacy |
|---|---|---|---|---|---|---|
| Ketamine versus placebo | ||||||
| Papadimitropoulou et al, 201732 | TR MDD | MA63 | 31 (1) no ECT | 5515 (35) | DB, P, vs PBO | Efficacy at week 2. No data at week 4, 6, and 8 |
| McCloud et al, 201530 | BD | Cochrane102,108 | 5 (2) no ECT | 329 (33) | DB, CO, vs PBO | Efficacy at day 1 and 3. No efficacy at week 1 and 2. |
| Romeo et al, 201533 | MDD, BD | MA68,102,108–111 | 6 (6) no ECT | 103 (103) | DB, CO, vs PBO | Efficacy at day 1, 2, 3–4 and week 1. No efficacy at week 2. |
| Caddy et al, 201434 | MDD, BD | MA102,108,110–112 | 5 (5) no ECT | 66 (66) | DB, CO, vs PBO except [101]: OL, P | Efficacy at 60–80 mins. No efficacy at 4 hrs, week 2. |
| Ketamine versus other comparators | ||||||
| Kishimoto et al, 201635 | MDD, BD | MA63,102,108–111,113,114 Lai et al, 2014 (case report) |
14 (9) no ECT | 588 (234) | DB, CO, P, vs PBO or active PBO | Efficacy at 40–60 mins, day 1, 5–8. No efficacy at week 2. |
| Xu et al, 201636 | TR MDD, BD | MA68,102,108–111,113,114 Loo unpublished data |
9 (9) no ECT | 201 (201) | DB, CO, P, vs PBO or active PBO | Efficacy at day 1 and 3. No efficacy at week 1. |
| Lee et al, 201537 | TR MDD, BD | MA102,108–111,113 | 5 (5) no ECT | 125 (125) | DB, CO, P vs PBO or active PBO | Efficacy at day 1 and week 1. |
| McGirr et al, 201538 | MDD, BD | MA68,102,108–111,113 | 7 (7) no ECT | 183 (183) | DB, CO, P vs PBO or active PBO | Efficacy at day 1. |
| Ketamine as pre-ECT anesthetic adjuvant versus placebo or active placebo | ||||||
| Ren et al, 201839 | MDD, BD | MA115–130 | 16 (16) ECT | 928 (928) | DB, OL, P, vs PBO or active PBO pre-ECT | Efficacy after the 1st, 3rd, 4th, 5th, 6th ECT. No efficacy after the 2nd, 8th, 10th, 12th ECT and at the end of ECT sessions. |
| McGirr et al, 201740 | MDD, BD | MA115–118,120,122–125,131 | 10 (10) ECT | 602 (602) | DB, P, vs PBO or active PBO pre-ECT | No efficacy at the end of ECT sessions. |
| Fond et al, 201641 | MDD, BD | MA115–119 | 14 (5) ECT | 610 (84) | DB, P, vs active PBO pre-ECT | No efficacy after the 6th ECT. |
| McGirr et al, 201542 | MDD, BD | MA115–119 | 5 (5) ECT | 182 (182) | DB, P, vs active PBO pre-ECT | No efficacy at the end of ECT sessions. |
| Ketamine alone and as pre-ECT anesthetic adjuvant versus placebo or active placebo | ||||||
| Caddy et al, 201531 | MDD, BD | Cochrane -113 -116 -109,110,111,115,117 -64 |
25: - 1 no ECT - 1 ECT - 5 no ECT+ECT - 1 no ECT |
1242: - 73 no ECT - 29 ECT - 130 no ECT + ECT - 18 no ECT |
DB - P, vs midazolam (no ECT) - P, vs thiopental (pre-ECT) - CO (no ECT), P (pre-ECT), vs PBO - SB, P, vs ECT |
No and pre-ECT: efficacy at day 1 (vs PBO, midazolam, ECT), day 3 (vs PBO, thiopental, ECT), week 1 (vs PBO, ECT). No efficacy at day 3 (vs midazolam), week 1 (vs midazolam), week 2 (vs PBO, thiopental, ECT), week 4 (vs thiopental). |
| Coyle and Laws, 201543 | MDD, BD | MA59,68,102,108–110,113,117,118,120,132–141 | 21 (21) no ECT and ECT | 437 (437) | RCT, no RCT, DB, OL, no ECT, pre-ECT | No and pre-ECT: efficacy at 4 hrs, day 1, week 1 and 2. |
| Newport et al, 201544 | MDD, BD | MA -68,102,108–111,113–119 |
12: - 7 no ECT - 5 ECT |
236: - 147 no ECT - 89 ECT |
DB, CO, P vs PBO or active PBO | No ECT: efficacy at day 1 and week 1. Pre-ECT: efficacy after the 1st ECT; no efficacy at the end of ECT sessions. |
| Fond et al, 201445 | MDD, BD | MA -64,90,108–113,142 -115,117–119 |
12: - 9 no ECT - 4 ECT |
310: - 192 no ECT - 118 ECT |
DB, CO, P - vs PBO or active PBO or vs ECT - vs PBO or active PBO pre-ECT |
No ECT: efficacy at day 1. Pre-ECT: efficacy at day 1. |
Abbreviations: RCT, randomized controlled trial; TR, treatment-resistant; MDD, major depressive disorder; BD, bipolar depression; MA, meta-analysis; ECT, electroconvulsive therapy; K, ketamine; PBO, placebo; DB, double-blind; SB, single-blind; OL, open-label; P, parallel; CO, cross-over.