Safety of Repeated Administration of Parenteral Ketamine for Depression
Abstract
1. Introduction
2. Results
2.1. Survey
2.2. Literature Review
3. Discussion
4. Methods
4.1. Survey
4.2. Literature Review
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Specialty | N (%) |
Psychiatry | 14 (51.9%) |
Anesthesia | 7 (25.9%) |
Emergency Medicine | 4 (14.8%) |
Primary Care | 1 (3.7%) |
Critical Care | 1 (3.7%) |
Pain and Palliative Care | 0 (0%) |
Practice Setting | N (%) |
Private Practice | 25(92.6%) |
Academic Medical Center | 0 (0%) |
Non-Academic Medical Center | 2 (7.4%) |
Adverse Effect | Cases Requiring Discontinuation * N (%) |
---|---|
Bladder Dysfunction | 3 (0.06%) |
Addiction ** | 0 (NA) |
Psychotic Symptoms | 1 (2%) |
Cognitive Deficits | 0 (NA) |
Psychological Distress | 33 (0.5%) |
Hypomania | 2 (0.03%) |
Hypertension | 0 (NA) |
Nausea *** | 6 (0.09%) |
Respiratory Distress *** | 1 (0.02%) |
Seizure *** | 1(0.02%) |
Total | 47 (0.7%) |
Report | Number of Patients | Ketamine Dose and Rate | Route | Dis-Continuation Due to AE | Other Notable AEs | Notes |
---|---|---|---|---|---|---|
Aan het Rot et al. [19] | 10 | 0.5 mg/kg /40 min | IV | 0 | 0 | No significant AEs |
Murrough et al. [20] | 24 | 0.5 mg/kg/40 min | IV | 0 | 0 | No significant AEs |
Zhou et al. [21] | 84 | 0.5 mg/kg/40 min | 1 (1.1%) | 0 | One patient withdrew due to a manic switch | |
Archer et al. [22] | 11 | 0.5 mg/kg/40 min | IV | 0 | 0 | No significant AEs |
Wilkinson et al. [23] | 14 | 0.5 mg/kg/40 min | IV | 0 | 0 | No significant AEs |
Phillips et al. [24] | 41 | 0.5 mg/kg/40 min | IV | 0 | 0 | No serious AE and no evidence of craving or drug-seeking behavior during the infusions or follow-up |
Vande Voort et al. [25] | 12 | 0.5 mg/kg/40 min | IV | 0 | 2 (1.7%) | 1 subject developed behavioral outbursts and suicide threats during follow-up while hospitalized, and another died by suicide several weeks after the end of follow-up. Authors did not attribute events these AEs to ketamine treatments |
Ionescu et al. [26] | 14 | 0.5 mg/kg/40 min for first 3 infusions; 75 mg/kg/40 min for last three | IV | Not reported | Not reported | AEs not reported |
Ionescu et al. [27] | 26 | 0.5 mg/kg/45 min | IV | 0 | 0 | |
Singh et al. [28] | 21 | 0.5 mg/kg/40 min | IV | 0 | 0 | 15–28% (twice weekly infusions) 6–41% (thrice weekly infusions) All symptoms resolved within 3 h of the infusions |
Shiroma et al. [29] | 12 | 0.5 mg/kg/40 min | IV | 0 | 2 (1.7%) | Single episode of vomiting effectively countered by IV labetalol and ondansetron |
Diamond et al. [30] | 28 | 0.5 mg/kg/40 min | IV | 2 (7.1%) | 5 (17.9%) | Two patients discontinued due to adverse reactions |
Bryant et al. [31] | 6 | 0.5 mg/kg/40 min | IV | 0 | 5 (83.3%) | panic attack (n = 1), rapid cycling of mood with a mild hypomanic episode (n = 1), emesis (n = 2) during treatment, symptomatic cystitis (n = 1), and a hypnogogic hallucination (n = 1) |
George et al. [32] | 10 | 0.3–0.5 mg/kg | SC | 0 | 2 (20%) | One patient reported the urge to urinate slightly more often. One patient had elevated aspartate aminotransferase (42–60) and alanine aminotransferase (25–44) after 12 treatments of 0.5 mg/kg |
Albott et al. [33] | 15 | 0.5 mg/kg/40 min | IV | 0 | 0 | No significant AEs |
Segmiller et al. [34] | 6 | 0.25 mg/kg/40 min | IV | 1 (16.7%) | 1 (16.7%) | One patient decided to discontinue before receiving all infusions due to the transient dissociative effects |
Szymkowicz et al. [35] | 3 | 0.5 mg/kg/40 min | IV | 0 | 2 (66.7%) | Transient hypomanic states over 12 months |
Blier et al. [36] | 1 | 0.5 mg/kg/40 min for most infusions | IV | 0 | 0 | No significant AEs |
Lopez-Diaz et al. [37] | 1 | 0.5 mg/kg/40 min | IV | 0 | 1 (100%) | Transient sedation during infusion |
TOTAL | 339 | 4 (1.2%) | 20 (5.9%) | Combined 24 (7.1%) |
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Feifel, D.; Dadiomov, D.; C. Lee, K. Safety of Repeated Administration of Parenteral Ketamine for Depression. Pharmaceuticals 2020, 13, 151. https://doi.org/10.3390/ph13070151
Feifel D, Dadiomov D, C. Lee K. Safety of Repeated Administration of Parenteral Ketamine for Depression. Pharmaceuticals. 2020; 13(7):151. https://doi.org/10.3390/ph13070151
Chicago/Turabian StyleFeifel, David, David Dadiomov, and Kelly C. Lee. 2020. "Safety of Repeated Administration of Parenteral Ketamine for Depression" Pharmaceuticals 13, no. 7: 151. https://doi.org/10.3390/ph13070151
APA StyleFeifel, D., Dadiomov, D., & C. Lee, K. (2020). Safety of Repeated Administration of Parenteral Ketamine for Depression. Pharmaceuticals, 13(7), 151. https://doi.org/10.3390/ph13070151