Is there evidence for using ketamine among individuals with dementia?

Area of Science:

• Neuroscience and Pharmacology
• Geriatric Psychiatry
• Clinical Neurology

Background:

• Dementia is frequently accompanied by behavioral disturbances, significantly impacting patient quality of life and care.
• Existing treatments for behavioral disturbances in dementia often have limited efficacy or significant side effects.
• Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has shown promise in treating mood disorders and agitation.

Purpose of the Study:

• To review and evaluate the current literature on the clinical application of ketamine in individuals diagnosed with dementia.
• To specifically assess the use of ketamine for managing behavioral disturbances, such as depression and agitation, in this population.

Main Methods:

• A narrative review of existing literature was conducted.
• Searches were performed across PubMed, Cochrane, and Ovid (Embase, APA PsycINFO, MEDLINE) databases.
• Inclusion criteria focused on studies detailing ketamine use in human dementia patients, excluding non-English articles, animal studies, and reviews.

Main Results:

• Three case reports met the inclusion criteria.
• Reported uses included subcutaneous ketamine for depression, intramuscular ketamine for agitation, and S-ketamine for anesthesia during electroconvulsive therapy.
• No significant adverse effects were documented in the reviewed case reports.

Conclusions:

• Ketamine demonstrates potential therapeutic value for depression and agitation associated with dementia.
• The current evidence base is limited, primarily consisting of case reports.
• High-quality prospective studies are essential to validate these findings and guide the safe clinical use of ketamine in dementia care.