Meta-analysis · 2025
Ketamine for teen depression: pooled trials show no clear mood benefit at 24 hours
- Original title
- Ketamine for major depression in adolescents: a systematic review and meta-analysis of efficacy and safety.
- Authors
- Magalhães IPA, Lopes DN, Amato I, et al.
- Journal
- International review of psychiatry (Abingdon, England), 2025
- Molecules
- Ketamine
- Conditions
- Depression, Suicidal ideation
- Participants
- 272
- Evidence grade
- Moderate
- Source
- Read the original paper
The question
Does ketamine quickly reduce depression symptoms in adolescents, and is it safe in this age group?
What they did
The authors searched the published literature for studies of ketamine given to young people with mood disorders, following standard review methods and registering the plan in advance. Four studies met their criteria, covering 272 adolescents aged 12 to 18. Three of those studies, with 189 participants in total, provided data that could be statistically combined. The main comparison was ketamine versus placebo at 24 hours after dosing.
What they found
At 24 hours, ketamine had only a small effect on depression symptoms compared with placebo, and it was not statistically significant (standardized mean difference -0.19; 95% confidence interval -0.41 to 0.04, a range that includes no effect). Rates of clinical response and of remission from depression did not differ significantly between ketamine and placebo. Remission of suicidal thinking was significantly more common with ketamine (risk ratio 1.49; 95% confidence interval 1.06 to 2.08). Side effects were described as generally mild, short-lived and in line with ketamine’s known effects.
The fine print
Only four studies and 272 adolescents were found, and just three studies with 189 participants could be pooled, so the estimates are imprecise. The main outcome was measured at 24 hours, which says nothing about lasting benefit or long-term safety. Combining a small number of studies can hide differences in how ketamine was given and who took part. This summary is based on the abstract alone.
What it means
In the small amount of evidence available so far, ketamine did not clearly improve adolescents’ depression symptoms in the first day after dosing, though it was linked to more remission of suicidal thinking; larger and longer trials are needed.
Evidence grade: Moderate. A systematic review and meta-analysis, but it pooled only three small studies with short follow-up, so the combined evidence is limited.
This summary is based on the study’s published abstract.