THE USE OF INTRAVENOUS KETAMINE IN THE TREATMENT OF RECURRENT DEPRESSION: A LITERATURE REVIEW

Abstract

This article aims to review the use of intravenous ketamine as an effective and rapid therapy for treatment-resistant depression (TRD). This literature review evaluated recent studies on the efficacy, safety, mechanisms of action, and dosing of ketamine across different population groups. Most articles indicated a significant reduction in depressive symptoms and suicidal ideation, with rapid clinical effects sustained for weeks, even in patients with multiple prior treatment failures. The safety profile was favorable, with mild and transient adverse events and no significant neurocognitive impairment. Studies suggest that the antidepressant mechanism of action is associated with modulation of neuroplasticity and glutamatergic pathways. Additionally, the subcutaneous route and various dosing regimens showed promising results. Analysis in specific populations, such as the elderly and adolescents, also demonstrated good tolerability, adherence, and treatment response. Despite advances, the durability of the drug’s effects and mandatory criteria for patient selection require further research. The findings reinforce ketamine’s role as a promising tool in managing TRD, providing an alternative for cases refractory to conventional therapy, with the need for individualized clinical monitoring.