The efficacy and safety of ketamine for depression in patients with cancer: A systematic review

Leila Azari; Homa Hemati; Ronia Tavasolian; Sareh Shahdab; Stephanie M Tomlinson; Margarita Bobonis Babilonia; Jeffrey Huang; Danielle B Tometich; Kea Turner; Heather S L Jim; Amir Alishahi Tabriz

doi:10.1016/j.ijchp.2023.100428

The efficacy and safety of ketamine for depression in patients with cancer: A systematic review

Int J Clin Health Psychol. 2024 Jan-Mar;24(1):100428. doi: 10.1016/j.ijchp.2023.100428. Epub 2023 Dec 15.

Authors

Leila Azari¹, Homa Hemati², Ronia Tavasolian³, Sareh Shahdab², Stephanie M Tomlinson⁴, Margarita Bobonis Babilonia^{5

6

7}, Jeffrey Huang⁸, Danielle B Tometich⁹, Kea Turner^{9

10}, Heather S L Jim^{9

10}, Amir Alishahi Tabriz^{9

10}

Affiliations

¹ University of South Florida Morsani College of Medicine, Tampa, FL, United States.
² College of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Clinical Science and Nutrition, University of Chester, England.
⁴ University of South Florida Health Libraries Morsani University of South Florida Morsani College of Medicine, Tampa, FL, United States.
⁵ Supportive Care Medicine Department, Behavioral Medicine Services, Moffitt Cancer Center, Tampa, FL, United States.
⁶ Department of Psychiatry and Behavioral Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, United States.
⁷ Department of Oncological Sciences, University of South Florida Morsani College of Medicine, Tampa, FL, United States.
⁸ Department of Anesthesiology, Moffitt Cancer Center, Tampa, FL, United States.
⁹ Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States.
¹⁰ Department of Oncological Sciences, University of South Florida Morsani College of Medicine, Tampa, FL, United States.

Abstract

Background: Management of depression in the oncology population includes supportive psychotherapeutic interventions with or without psychotropic medication, which take time to demonstrate effectiveness. Fast-acting interventions, like ketamine, can provide a rapid antidepressant effect; however, there has been limited research on effects of ketamine among cancer patients. The objective of this review is to provide an overview of research on the efficacy and safety of ketamine on depression in patients with cancer.

Methods: We reviewed the published literature in MEDLINE® (via PubMed®), EMBASE, and Scopus from 1 January 1982 to 20 October 2022. We screened the retrieved abstracts against inclusion criteria and conducted a full-text review of eligible studies. Following extraction of data from included studies, we used a framework analysis approach to summarize the evidence on using ketamine in patients with cancer.

Results: All 5 included studies were randomized clinical trials conducted in inpatient settings in China. In all included studies ketamine was administered intravenously. Three studies used only racemic ketamine, and two studies used both S-ketamine and racemic ketamine. All included studies reported ketamine a tolerable and effective drug to control depression symptoms.

Conclusion: Included studies showed administration of sub-anesthesia ketamine significantly improves postoperative depression among patients with cancer.

Keywords: Antidepressant; Cancer; Depression; Ketamine; Systematic review.