Cochrane · systematic review · CD011611

Ketamine and other glutamate receptor modulators for depression in adults with bipolar disorder

Dean, RL, Marquardt, T, Hurducas, C, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library

Common Mental Disorders2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
33
current version
GRADE rated
22
No studies
11
Included studies
NR
No studies 11 · 33.3%Ungraded 0 · 0%Very low 15 · 45.5%Low 7 · 21.2%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Ketamine compared to placebo for adults with depression in bipolar disorder

Population: adults (aged 18 years+) with depression in bipolar disorder
5 questions
OutcomeEffectEvidenceStatus / GRADE
Efficacy: number of participants who respond to treatment ‐ at 24 hours
Ketamine vs placebo
OR 11.61 [1.25, 107.74]2 studies · 33 participantsLow
Downgraded: imprecision
Efficacy: number of participants who achieve remission ‐ at 1 week
Ketamine vs placebo
OR 3.35 [0.12, 93.83]1 study · 18 participantsVery low
Depression rating scale score ‐ at 1 week
Ketamine vs placebo
no estimate extracted2 studies · 28 participantsVery low
Acceptability: total dropouts
Ketamine vs placebo
OR 3.48 [0.56, 21.74]2 studies · 33 participantsVery low
Acceptability: dropouts due to adverse effects
Ketamine vs placebo
no estimate extractedNRNo studies

Ketamine compared to midazolam for adults with depression in bipolar disorder

Population: adults (aged 18 years+) with depression in bipolar disorder
5 questions
OutcomeEffectEvidenceStatus / GRADE
Efficacy: number of participants who respond to treatment ‐ at 24 hours
Ketamine vs midazolam
OR 3.2 [0.23, 45.19]1 study · 16 participantsVery low
Downgraded: risk of bias
Efficacy: number of participants who achieve remission ‐ at 24 hours
Ketamine vs midazolam
OR 1.33 [0.07, 25.91]1 study · 16 participantsVery low
Downgraded: risk of bias
Depression rating scale score ‐ at 24 hours
Ketamine vs midazolam
no estimate extracted1 study · 16 participantsVery low
Downgraded: risk of bias
Acceptability: dropouts due to adverse effects at 24 hours
Ketamine vs midazolam
no estimate extracted1 study · 16 participantsVery low
Downgraded: risk of bias
Acceptability: total dropouts
Ketamine vs midazolam
no estimate extracted1 study · 16 participantsVery low
Downgraded: risk of bias

Memantine compared to placebo for adults with depression in bipolar disorder

Population: adults (aged 18 years+) with depression in bipolar disorder
8 questions
OutcomeEffectEvidenceStatus / GRADE
Efficacy: number of participants who respond to treatment ‐ at 1 week
Memantine vs placebo
OR 1.08 [0.06, 19.05]1 study · 29 participantsVery low
Downgraded: imprecision
Efficacy: number of participants who respond to treatment ‐ at 2 weeks
Memantine vs placebo
OR 4.88 [0.78, 30.29]1 study · 29 participantsVery low
Downgraded: imprecision
Efficacy: number of participants who respond to treatment ‐ at 4 weeks
Memantine vs placebo
OR 5.33 [1.02, 27.76]1 study · 29 participantsVery low
Downgraded: imprecision
Efficacy: number of participants who respond to treatment ‐ at 3 months
Memantine vs placebo
OR 1.66 [0.69, 4.03]2 studies · 261 participantsLow
Downgraded: imprecision
Efficacy: number of participants who achieve remission ‐ at 1 week
Memantine vs placebo
OR 1.08 [0.06, 19.05]1 study · 29 participantsVery low
Downgraded: imprecision
Depression rating scale score ‐ at 3 months
Memantine vs placebo
no estimate extracted1 study · 157 participantsLow
Acceptability: total dropouts
Memantine vs placebo
OR 0.77 [0.45, 1.31]2 studies · 261 participantsLow
Downgraded: imprecision
Acceptability: dropouts due to adverse effects
Memantine vs placebo
OR 0.34 [0.01, 8.34]1 study · 232 participantsLow
Downgraded: imprecision

Cytidine compared to placebo for adults with depression in bipolar disorder

Population: adults (aged 18 years+) with depression in bipolar disorder
5 questions
OutcomeEffectEvidenceStatus / GRADE
Efficacy: number of participants who respond to treatment ‐ at 3 months
Cytidine vs placebo
OR 1.13 [0.3, 4.24]1 study · 35 participantsVery low
Downgraded: imprecision
Efficacy: number of participants who achieve remission
Cytidine vs placebo
no estimate extractedNRNo studies
Depression rating scale score
Cytidine vs placebo
no estimate extractedNRNo studies
Acceptability: total dropouts
Cytidine vs placebo
OR 0.94 [0.12, 7.52]1 study · 35 participantsVery low
Downgraded: imprecision
Acceptability: dropouts due to adverse effects
Cytidine vs placebo
no estimate extractedNRNo studies

N‐acetylcysteine compared to placebo for adults with depression in bipolar disorder

Population: adults (aged 18 years+) with depression in bipolar disorder
5 questions
OutcomeEffectEvidenceStatus / GRADE
Efficacy: number of participants who respond to treatment ‐ at 3 months
N‐acetylcysteine vs placebo
OR 0.82 [0.32, 2.14]2 studies · 69 participantsLow
Downgraded: imprecision
Efficacy: number of participants who achieve remission ‐ not reported
N‐acetylcysteine vs placebo
no estimate extractedNRNo studies
Depression rating scale score ‐ at 3 months
N‐acetylcysteine vs placebo
no estimate extracted2 studies · 58 participantsLow
Downgraded: imprecision
Acceptability: total dropouts ‐ not reported
N‐acetylcysteine vs placebo
no estimate extractedNRNo studies
Acceptability: dropouts due to adverse effects ‐ not reported
N‐acetylcysteine vs placebo
no estimate extractedNRNo studies

Riluzole compared to placebo for adults with depression in bipolar disorder

Population: Adults (aged 18 years+) with depression in bipolar disorder
5 questions
OutcomeEffectEvidenceStatus / GRADE
Efficacy: number of participants who respond to treatment ‐ not reported
Riluzole vs placebo
no estimate extractedNRNo studies
Efficacy: number of participants who achieve remission ‐ not reported
Riluzole vs placebo
no estimate extractedNRNo studies
Depression rating scale scores ‐ not reported
Riluzole vs placebo
no estimate extractedNRNo studies
Acceptability: total dropouts
Riluzole vs placebo
OR 2 [0.31, 12.84]1 study · 19 participantsVery low
Acceptability: dropouts due to adverse effects ‐ not reported
Riluzole vs placebo
no estimate extractedNRNo studies