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Compounded oral ketamine
Jack P McNulty1, Kristian Hahn
1Hospice of St. Tammany, Covington, Louisiana, USA.
International Journal of Pharmaceutical Compounding
|October 18, 2012
Summary
Low-dose ketamine offers significant relief for hospice patients suffering from severe anxiety, depression, and chronic pain. This case report details the successful use of oral ketamine for sustained symptom management in palliative care.
Area of Science:
- Anesthesiology
- Palliative Care
- Psychiatry
Background:
- Ketamine, initially an anesthetic, is now explored for non-narcotic pain, depression, and anxiety relief.
- Traditional ketamine use is limited to intravenous administration in hospitalized patients.
- Chronic pain, depression, and anxiety are prevalent in hospice and palliative care populations.
Purpose of the Study:
- To report the successful use of low-dose ketamine in a hospice patient with refractory symptoms.
- To evaluate ketamine's efficacy for the triad of chronic pain, anxiety, and depression in palliative care.
- To document the first use of compounded oral ketamine for home-based hospice care in Louisiana.
Main Methods:
- A single subcutaneous low-dose (0.5 mg/kg) ketamine injection was administered.
- Daily treatment with a compounded, flavored oral ketamine solution (40 mg/5 mL) was initiated.
- Patient presented with severe anxiety, depression, and chronic pain due to multiple comorbid conditions.
Main Results:
- A single ketamine injection provided 80 hours of dramatic symptom relief.
- Daily oral ketamine solution effectively sustained symptom management.
- Ketamine was well-tolerated, with no significant adverse effects reported.
Conclusions:
- Low-dose ketamine is a well-tolerated and effective treatment for severe anxiety, chronic pain, and depression in hospice patients.
- Compounded oral ketamine offers a palatable and effective option for home-based palliative and hospice care.
- This case highlights ketamine's potential in managing complex symptoms in end-of-life care.
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