A systematic scoping review of Indian literature on ketamine use for treating psychiatric disorders

This scoping review aims to systematically explore the use of ketamine for treating psychiatric disorders in India, mapping the landscape of research, and identifying gaps in the existing literature. The electronic literature search was conducted using PubMed, Scopus, and Clinical Trials Registry of India databases to identify both published and ongoing studies exploring ketamine's efficacy and safety in treating psychiatric disorders in India. Twenty published studies and 29 trial protocols were included. Published studies comprised case reports (n = 8), case series (n = 2), prospective uncontrolled investigations (n = 5), retrospective reviews (n = 2), and randomized controlled trials (RCTs, n = 3). Most of them focused on ketamine infusion treatment for resistant depression and suicidality. An analysis of trial protocols revealed a significant number of RCTs (n = 26/29), with two non-randomized and one single-arm trial. The majority of trials focused on unipolar depression or suicidality, with other psychiatric conditions such as obsessive-compulsive disorder (OCD) and bipolar depression being explored in some trials. The review of the literature indicated a growing interest in exploring alternative routes of ketamine administration such as oral and subcutaneous, which contrasts with the predominantly intravenous administration reported in published studies. However, careful consideration of dosing, administration routes, and medical supervision is essential to maximize the benefits and minimize the risks. The review highlights the need for more methodologically rigorous research to optimize treatment protocols and expand ketamine's therapeutic applications in psychiatric practice.