Evidence map›Paper›PMID 28739263›Full record

Trial reportThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2017

Pilot Randomized Controlled Trial of Titrated Subcutaneous Ketamine in Older Patients with Treatment-Resistant Depression.

Duncan George, Verònica Gálvez, Donel Martin, Divya Kumar, John Leyden, Dusan Hadzi-Pavlovic, Simon Harper, Henry Brodaty, Paul Glue, Rohan Taylor and 2 more

4 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 48 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01441505 phase2unknown statusnot on this map

A Study of Ketamine as an Antidepressant

TypeinterventionalSponsorThe University of New South WalesRan2011 to 2014Enrolled42ConditionsMajor Depressive EpisodeArmsKetamine, Saline or Midazolam (active placebo)
NCT03473431 nacompletednot on this mapstarted 2018, after this paper: background citation

A Pilot Study of a Single Infusion of Ketamine in Relief of Depressive Symptoms of Elderly Patients With Visual Impairment.

TypeinterventionalSponsorInstituto Mexicano del Seguro SocialRan2018 to 2018Enrolled90ConditionsDepression in Old Age, KetamineArmsKetamine, control
NCT04658420 phase2unknown statusnot on this mapstarted 2021, after this paper: background citation

A Single Ketamine Infusion Combined With Music for Suicidal Ideation During a Depressive Episode: A Randomized Open Label Clinical Trial

TypeinterventionalSponsorThe University of Texas Health Science Center at TylerRan2021 to 2023Enrolled200ConditionsSuicidal Ideation, Depressive EpisodeArmsKetamine Hydrochloride, Music
NCT06957704 phase3not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Evaluation of the Efficacy and Safety of Subcutaneous Ketamine in the Treatment of Depressive Episode With Suicidal Ideation and/or Behavior in Adolescents

TypeinterventionalSponsorFederal University of São PauloRan2025 to 2028Enrolled60ConditionsDepressive Disorder, Suicidal IdeasArmsketamine, Midazolam
3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Development of the Ketamine Side Effect Tool (KSET).Journal of affective disorders · 2020
    Pooled it
  7. Trial
  8. Trial
  9. Intravenous Ketamine for Late-Life Treatment-Resistant Depression: A Pilot Study of Tolerability, Safety, Clinical Benefits, and Effect on Cognition.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2023
    Trial
  10. Trial
  11. Trial
  12. Identification of an optimal dose of intravenous ketamine for late-life treatment-resistant depression: a Bayesian adaptive randomization trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022
    Trial
  13. Trial
  14. Ketamine or Esketamine in Special Populations of Patients With Treatment-Resistant Depression.Medical science monitor : international medical journal of experimental and clinical research · 2026
    Review
  15. The spectrum of bipolar disorder in older adults.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Review
  16. Article
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Duncan GeorgeSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Black Dog Institute, Sydney, New South Wales, Australia.
Verònica GálvezSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Black Dog Institute, Sydney, New South Wales, Australia.
Donel MartinSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Black Dog Institute, Sydney, New South Wales, Australia.
Divya KumarSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
John LeydenRoyal North Shore Hospital, St. Leonards, New South Wales, Australia; Wesley Hospital, Kogarah, New South Wales, Australia.
Dusan Hadzi-PavlovicSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Black Dog Institute, Sydney, New South Wales, Australia.
Simon HarperSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Wesley Hospital, Kogarah, New South Wales, Australia.
Henry BrodatyCentre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia; Dementia Centre for Research Collaboration, University of New South Wales, Sydney, New South Wales, Australia; School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
Paul GlueDunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Rohan TaylorSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Black Dog Institute, Sydney, New South Wales, Australia.
Philip B MitchellSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Black Dog Institute, Sydney, New South Wales, Australia.
Colleen K LooSchool of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Black Dog Institute, Sydney, New South Wales, Australia; Wesley Hospital, Kogarah, New South Wales, Australia; St. George Hospital, Sydney, New South Wales, Australia. Electronic address: colleen.loo@unsw.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the efficacy and safety of subcutaneous ketamine for geriatric treatment-resistant depression. Secondary aims were to examine if repeated treatments were safe and more effective in inducing or prolonging remission than a single treatment.

methodsIn this double-blind, controlled, multiple-crossover study with a 6-month follow-up (randomized controlled trial [RCT] phase), 16 participants (≥60 years) with treatment-resistant depression who relapsed after remission or did not remit in the RCT were administered an open-label phase. Up to five subcutaneous doses of ketamine (0.1, 0.2, 0.3, 0.4, and 0.5 mg/kg) were administered in separate sessions (≥1 week apart), with one active control (midazolam) randomly inserted (RCT phase). Twelve ketamine treatments were given in the open-label phase. Mood, hemodynamic, and psychotomimetic outcomes were assessed by blinded raters. Remitters in each phase were followed for 6 months.

resultsSeven of 14 RCT-phase completers remitted with ketamine treatment. Five remitted at doses below 0.5 mg/kg. Doses ≥ 0.2 mg/kg were significantly more effective than midazolam. Ketamine was well tolerated. Repeated treatments resulted in higher likelihood of remission or longer time to relapse.

conclusionResults provide preliminary evidence for the efficacy and safety of ketamine in treating elderly depressed. Dose titration is recommended for optimizing antidepressant and safety outcomes on an individual basis. Subcutaneous injection is a practical method for giving ketamine. Repeated treatments may improve remission rates (clinicaltrials.gov; NCT01441505).

Indexed as

Outcome Assessment, Health CareAgedCross-Over StudiesDepressive Disorder, Treatment-ResistantDouble-Blind MethodDrug Administration ScheduleExcitatory Amino Acid AntagonistsFemaleFollow-Up StudiesHumansHypnotics and SedativesInjections, SubcutaneousKetamineMaleMidazolamMiddle AgedExcitatory Amino Acid AntagonistsHypnotics and SedativesKetamineMidazolamdepressiondosegeriatricKetaminerandomized controlled trialsubcutaneous

Identifiers

PMID28739263

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.