Full-text articles available in English were included for review, while certain criteria were applied to ensure the reliability and validity of the analysis. Though this seems like a promising approach, we should keep in mind the potential risks of long-term administration of ketamine. Furthermore, though some side effects of ketamine (e.g., increased blood pressure, dissociation) are already known, long-term side effects of ketamine infusion are not well understood. A trained facilitator can assist patients in understanding and integrating the insights gained during the session into their daily lives.
- He had been seen in psychiatric follow up the week of his death and had been in a heated argument with an ex-spouse the day of his suicide.
- Ketamine has shown to be an effective treatment in rapidly decreasing depressive symptoms in those with depression.
- Some people find it more pleasant to have an eye mask on and listen to calming music.
EAU aims to warn about the dangerous impact of ketamine on the brain, applicable regulations and laws, and the risks and transmission methods of infectious diseases, such as HIV and hepatitis C83. According to the study, IBM is more effective at increasing awareness and knowledge about ketamine use and abuse (105). Although ketamine shows promise in treating various diseases, its psychoactive side effects and abuse potential limit its widespread use26. Recreational doses are about 15–20% lower than anesthetic doses, and its anesthetic and reinforcing effects contribute to its misuse globally. A 2006 U.S. survey reported that 2.3 million adolescents and adults had used ketamine at least once24.
Ketamine for chronic pain
As such, it should be used responsibly and ethically, with the patient’s safety and well-being prioritized at every step. A trained facilitator with a deep understanding of ketamine’s effects on the brain and body can ensure that the treatment is used as part of an ethical, holistic approach to care. This is crucial for minimizing risks and ensuring that ketamine is a helpful, rather than harmful, tool in the healing process. The main limitation of this report is the one patient included for the prolonged follow-up, thus generalization to others should be limited.
Ketamine Infusion for Chronic Pain
To promote effective ketamine use, various psychiatric and anesthesiology institutions, such as the Integrative Psychiatry Institute (IPI) and the Ketamine Research Institute, offer courses and training for clinicians on best practices74-77. Given the safety concerns and risks, including its potential for abuse, healthcare providers must follow strict guidelines to ensure ketamine’s safe use in clinical settings13. Healthcare providers need to apply these guidelines to ensure the safe and effective use of ketamine in clinical practice12.
About this article
Ketamine is an anaesthetic drug that has caused polarizing tumult ever since its successful introduction to clinical practice in 1970 (reviewed by Domino 8). Ketamine immediately found a role in battlefield anaesthesia during the Vietnam conflict, where its safety (because of relative lack of cardiorespiratory depressant effects) and its analgesic properties were advantageous. It was the first of the class of ‘dissociative’ anaesthetic agents and has remained an integral part of the clinical anaesthetic armamentarium for emergencies, for paediatrics and as a component of sedation for invasive medical procedures 9. Since its earliest introduction it has also been a drug of abuse, taken for its hallucinogenic and euphoric actions (like phencyclidine). Within this setting, it causes both morbidity (e.g. bladder pathology) and mortality through overdose-related aspiration or psychotic delusions leading to self-harm 10. If ketamine infusion therapy is not a suitable option for you, there are several alternative treatments and lifestyle changes that may help manage your condition.
What does ketamine therapy feel like?
From potential side effects to dosage, it is safe to say that the medical community knows almost everything there is to know about ketamine, though it continues to be understood better and better as its use cases expand. A current study, ELEKT-D, is underway to attempt to compare the efficacy of ketamine and ECT in those with TRD. Hopefully, the ELECKT-D study can shed some light on the efficacy of ketamine compared to ECT in those with TRD 26. A recent study has shown that ketamine can cause a decrease in acute suicidal ideation for at least six weeks when used as an adjunct therapy with anti-depressant therapy 1. The researchers hypothesize that this increased length of efficacy is due to the participants remaining on their antidepressants during this study. Ketamine’s duration of efficacy for treatment of acute suicidal ideation should be further researched before more concrete conclusions can be made.
While ketamine therapy ketamine infusion therapy: techniques and efficacy isn’t typically a first-line treatment, it may be an option if other pain management strategies haven’t worked. Since coming to Stanford in 2015, Rodriguez has been funded by the National Institute of Mental Health for a large clinical trial of ketamine’s effects on OCD. This five-year trial aims to follow 90 OCD patients for as long as six months after they’ve been given a dose of ketamine or an alternative drug. Rodriguez and her research team want to observe how ketamine changes participants’ brains, as well as test for side effects. As mentioned before a large body of evidence regarding the risks of ketamine comes from studies on the recreational use and chronic abuse of ketamine.
- Forced by germ obsessions to compulsively wash and rewash his hands, he started wearing gloves all day to both protect him from the germs and stop him from washing his hands raw.
- In 2013, Rodriguez and colleagues published their results from that first clinical trial of ketamine in OCD patients.
- Cvrček concluded that ketamine treatment, while not optimal, is acceptable for treatment of chronic pain.
- The patient was placed in the supine position with the head rotated slightly to the left, with monitoring per clinic protocol.
Electroconvulsive therapy (ECT) can be a highly effective treatment for severe depression and other medication-resistant mental health disorders. One small study looked at using KAP in a group setting to treat 10 frontline healthcare workers who were experiencing symptoms of burnout, PTSD, depression, and anxiety during the COVID-19 pandemic.19 Treatment involved six weekly sessions at a private clinic. The results showed significant improvements in participants’ average scores for PTSD (59% reduction), depression (58% reduction), and anxiety (36% reduction) following treatment.
As discussed above, soldiers from the SOF community are likely to present with a PTSD/TBI mixed presentation. It seems likely that TBI and PTSD can be produced by overlapping pathophysiological changes that disrupt neural connections, termed the “connectome” 27. The neural disruptions shared by PTSD and TBI, as well as the comorbid conditions, include asymmetrical white matter tract abnormalities and gray matter changes in the basolateral amygdala, hippocampus, and prefrontal cortex. These disturbances produce neuronal death and degeneration, axonal injury, and dendritic spine dysregulation and changes 27.
EL performed sympathetic blocks, analyzed the data and drafted the original manuscript. And A.S.E. conceived the idea, designed the research workflow, and searched the databases. Based in attachment theory, attachment-based therapy helps you explore how your earliest experiences with caregivers taught you to form relationships.
Table 1. Primary migraine phase progression and associated clinical symptoms .
For these parenteral infusion protocols, this will require hospitalization and close observation and will have a cost implication; to date, no cost–benefit analysis has been published. An additional complication is that prolonged infusion of ketamine is known to cause hepatic dysfunction (see review 32). This came to light when half of the subjects in a trial of repeated courses of ketamine infusions for CRPS developed elevated liver enzymes 33, resulting in the study being halted early. Although these elevations were slowly reversible, it clearly raises concerns about the safety of repeated dosing.
The field of ketamine therapy is still evolving, with ongoing research exploring its long-term effects, optimal dosing protocols, and potential applications for other conditions. Patients considering this treatment should stay informed about the latest developments and work closely with their healthcare team to make informed decisions. SUD tends to occur in patients who have concomitant mental health disorders, such as patients with schizophrenia, patients suffering from depression 29,30.