Ketamine for treatment-resistant depression

Depression in late‐life increases the risk of physical disability, dementia, and overall mortality, all of which can be mitigated with treatment. Treatment‐resistant depression (TRD) is typically defined as depression that does not improve after at least two adequate trials of antidepressant medications.
Repeated intravenous (IV) ketamine infusions are well‐tolerated, feasible, and may be beneficial for older adults with TRD.
It is recommended to begin with 2 IV Ketamine Infusions twice weekly for 3 weeks and transition to a weekly Ketamine Infusion.

Vanderschelden B, Gebara MA, Oughli HA, et al. Change in patient-centered outcomes of psychological well-being, sleep, and suicidality following treatment with intravenous ketamine for late-life treatment-resistant depression. International Journal of Geriatric Psychiatry. 2023 Jul;38(7):e5964. DOI: 10.1002/gps.5964. PMID: 37392089.