Evidence map›Paper›PMID 33022440›Full record

SynthesisJournal of affective disorders2021

Comparative efficacy of racemic ketamine and esketamine for depression: A systematic review and meta-analysis.

Anees Bahji, Gustavo H Vazquez, Carlos A Zarate

Erratum issued Registry-linked trialOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of affective disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06773143 (Effect of Subanesthetic Dose of Esketamine on Sleep Quality in Patients With Breast Cancer After Chemotherapy), which is not on this map. Cited by 161 papers, 26 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
161citing papers in PubMed, 26 pooled it
31.5field-weighted citation impact, top 1% of its field
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.

NCT06773143 narecruitingnot on this mapstarted 2024, after this paper: background citation

Effect of Subanesthetic Dose of Esketamine on Sleep Quality in Patients With Breast Cancer After Chemotherapy

TypeinterventionalSponsorNanjing First Hospital, Nanjing Medical UniversityRan2024 to 2027Enrolled184ConditionsInsomnia, Breast Cancer Surgery, EsketamineArmsEsketamine at low dose, Normal Saline (0.9% NaCl)
3 · Its place in the literature

Who cites it

161 citing papers in PubMed, 26 syntheses or guidelines pooled it, 379 citations in OpenAlex.

  1. Safety and tolerance of oral ketamine: A systematic review.Psychiatry and clinical neurosciences · 2026
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  12. Ketamine in fibromyalgia: a systematic review.Advances in rheumatology (London, England) · 2024
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101 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 2 countries.

Anees BahjiDepartment of Psychiatry, Queen's University, Kingston, ON, Canada; Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
Gustavo H VazquezDepartment of Psychiatry, Queen's University, Kingston, ON, Canada.
Carlos A ZarateSection Neurobiology and Treatment of Mood Disorders, Division of Intramural Research Program, National Institute of Mental Health, 10 Center Drive, MSC 1282 Building 10CRC, Room 7-5342, Bethesda, MD 20892, USA. Electronic address: zaratec@mail.nih.gov.
Queen's University · CANational Institute of Mental Health · US

Funding

Glutamatergic Modulators for Rapid & Sustained Antidepressant EffectZIAMH002857 · NIMH · NATIONAL INSTITUTE OF MENTAL HEALTH · PI ZARATE, CARLOS · 2009 to 2025
$55.0M
Intramural NIH HHS ZIA MH002857
6 · The paper itself

Abstract

backgroundKetamine appears to have a therapeutic role in certain mental disorders, most notably depression. However, the comparative performance of different formulations of ketamine is less clear.

objectivesThis study aimed to assess the comparative efficacy and tolerability of racemic and esketamine for the treatment of unipolar and bipolar major depression.

designSystematic review and meta-analysis. DATA SOURCES: We searched PubMed, MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Clinical Trials, and the Cochrane Database of Systematic Reviews for relevant studies published since database inception and December 17, 2019. STUDY ELIGIBILITY CRITERIA: We considered randomized controlled trials examining racemic or esketamine for the treatment of unipolar or bipolar major depression. OUTCOMES: Primary outcomes were response and remission from depression, change in depression severity, suicidality, retention in treatment, drop-outs, and drop-outs due to adverse events. ANALYSIS: Evidence from randomized controlled trials was synthesized as rate ratios (RRs) for treatment response, disorder remission, adverse events, and withdrawals and as standardized mean differences (SMDs) for change in symptoms, via random-effects meta-analyses.

findings24 trials representing 1877 participants were pooled. Racemic ketamine relative to esketamine demonstrated greater overall response (RR = 3.01 vs. RR = 1.38) and remission rates (RR = 3.70 vs. RR = 1.47), as well as lower dropouts (RR = 0.76 vs. RR = 1.37).

conclusionsIntravenous ketamine appears to be more efficacious than intranasal esketamine for the treatment of depression.

Indexed as

KetamineMajor Depressive DisorderAntidepressive AgentsDepressionHumansAntidepressive AgentsEsketamineKetamineBipolar disorderDepressionDepressive disorderEsketamineKetamineMajorMeta-analysisRandomized controlled trials

Identifiers

PMID33022440
PMCPMC7704936
OpenAlexW3088001093

What OpenQuestion holds

Textmetadata
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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.