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Severe depression in adolescents significantly contributes to global disease burden due to disability and lost productivity. Major depressive disorder (MDD) and treatment-resistant depression (TRD) are often underdiagnosed and undertreated in this age group. Standard treatments, such as selective serotonin reuptake inhibitors (SSRIs) and psychotherapy, show inadequate response in 30–40% of adolescents, increasing the risk of suicidal behavior. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has emerged as a potential treatment option for adolescent MDD and TRD due to its rapid onset of action and ability to reduce suicidal ideation. However, concerns about its neurotoxic effects, potential for abuse, and long-term safety in the developing adolescent brain remain unresolved. Early clinical trials suggest ketamine’s effectiveness in youth is comparable to that in adults, but data are limited by small sample sizes and short observation periods. More extensive randomized clinical trials (RCTs) are needed to better understand optimal dosing, administration schedules, and the long-term impacts of ketamine use in adolescents.

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Therapeutic Ketamine in Youth with Major Depression Versus Illicit Use: Initial Clinical Findings with Short-Term Benefits and Long-Term Unknowns

  • 实验方案

  • 发表日期：

    2025年

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  • Malgorzata Zaremba,
  • Patrycja Kleczkowska

摘要

Severe depression in adolescents significantly contributes to global disease burden due to disability and lost productivity. Major depressive disorder (MDD) and treatment-resistant depression (TRD) are often underdiagnosed and undertreated in this age group. Standard treatments, such as selective serotonin reuptake inhibitors (SSRIs) and psychotherapy, show inadequate response in 30–40% of adolescents, increasing the risk of suicidal behavior. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has emerged as a potential treatment option for adolescent MDD and TRD due to its rapid onset of action and ability to reduce suicidal ideation. However, concerns about its neurotoxic effects, potential for abuse, and long-term safety in the developing adolescent brain remain unresolved. Early clinical trials suggest ketamine’s effectiveness in youth is comparable to that in adults, but data are limited by small sample sizes and short observation periods. More extensive randomized clinical trials (RCTs) are needed to better understand optimal dosing, administration schedules, and the long-term impacts of ketamine use in adolescents.