Health Problem: Treatment-resistant depression (TRD) is typically defined as depression that does not respond to at least 2 attempts at treatment of adequate duration with appropriate doses of antidepressants, but there is no official consensus definition.

Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after an individual experiences or witnesses actual or threatened death or serious injury to him/herself or someone else, and reacts to the event with a feeling of fear, helplessness, and/or horror.

Technology Description: Ketamine therapy for unipolar depression or PTSD often involves infusing a subdissociative dose of ketamine hydrochloride intravenously. Patients are awake during the procedure, but an anesthesiologist or other qualified healthcare professional is often present for patient monitoring since ketamine is typically used as a dissociative anesthetic.

Controversy: Early evidence for the antidepressant effect of ketamine came from uncontrolled studies, and TRD may have diverse causes and poor response rates that make it difficult to demonstrate whether or not ketamine treatment is effective.

Key Questions:

  • Does ketamine reduce or eliminate the symptoms of treatment-resistant unipolar depression or PTSD?
  • How does ketamine compare with other strategies for treating treatment-resistant unipolar depression or PTSD?
  • Is ketamine a safe therapy for treatment-resistant unipolar depression and PTSD?
  • Have definitive patient selection criteria been established for use of ketamine as a therapy for treatment-resistant unipolar depression or PTSD?

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