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Psychedelic Therapy: A Primer for Primary Care Clinicians-Ketamine
Viviana D Evans1, Alejandro Arenas2, Kenneth Shinozuka3,4
1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
Ketamine offers rapid antidepressant and pain relief, but its effects may wane, requiring repeated doses. This versatile anesthetic shows promise for various psychiatric conditions and pain management.
Area of Science:
- Pharmacology and Psychiatry
- Anesthesiology
Background:
- Ketamine, an arylcyclohexylamine anesthetic, has demonstrated versatility in therapeutic applications.
- Esketamine, its enantiomer, received FDA approval in 2019 for treatment-resistant depression and major depressive disorder with suicidal ideation.
Purpose of the Study:
- To review the therapeutic applications and risks of ketamine.
- To evaluate ketamine's efficacy in treating depression, PTSD, suicidal ideation, and chronic pain.
Main Methods:
- Review of existing research on ketamine's clinical effects and safety profile.
- Analysis of data on ketamine's impact on depression, PTSD, suicidal ideation, and pain management.
Main Results:
- Single intravenous ketamine infusions show rapid antidepressant effects (d = 0.96 at 24 hours).
- Ketamine effectively reduces PTSD and suicidal ideation symptoms and revolutionizes postoperative pain management.
- Potential risks include dose-dependent cognitive effects, liver toxicity, and ketamine cystitis.
Conclusions:
- Ketamine's therapeutic benefits, particularly for depression and suicidal ideation, may require repeated administrations for sustained effects.
- Ketamine presents a significant therapeutic potential for a range of psychiatric conditions and chronic pain.
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