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Zarate CA, Singh JB, Carlson PJ, et al. A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression. Arch Gen Psychiatry. 2006;63(8):856–864. doi:10.1001/archpsyc.63.8.856
Berman RM, Cappiello A, Anand A, Oren DA, Heninger GR, Charney DS, Krystal JH. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry. 2000 Feb 15;47(4):351-4.
aan het Rot M1, Collins KA, Murrough JW, Perez AM, Reich DL, Charney DS, Mathew SJ. Safety and efficacy of repeated-dose intravenous ketamine for treatment-resistant depression. Biol Psychiatry. 2010 Jan 15;67(2):139-45. doi: 10.1016/j.biopsych.2009.08.038.
Luckenbaugh DA1, Niciu MJ1, Ionescu DF1, Nolan NM1, Richards EM1, Brutsche NE1, Guevara S1, Zarate CA2. Do the dissociative side effects of ketamine mediate its antidepressant effects? J Affect Disord. 2014 Apr;159:56-61. doi: 10.1016/j.jad.2014.02.017. Epub 2014 Feb 18.
Murrough, Perez, et al. “Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression” Biological Psychiatry 2013 Aug 15; 74(4): 250–256.
Shiroma, Johns et al. “Augmentation of response and remission to serial intravenous subanesthetic ketamine in treatment resistant depression” Journal of Affective Disorders. 2014 Feb;155:123-9.
Bipolar disorder or manic-depressive illness, involve unusual shifts in mood, energy, activity levels, and the ability to carry out of daily activities. It is the sixth leading cause of disability worldwide. Bipolar I, II, cyclothymia, and specified/unspecific and other related disorder are the four classified types of this condition. Medications such as mood stabilizers, atypical antipsychotics, antidepressants, in addition to psychotherapy and electroconvulsive treatment may provide relief. Mood changes readily occur even with proper treatment and relapse is occurs in 40-60% of patients.
Lener, Marc S et al. “Ketamine and Beyond: Investigations into the Potential of Glutamatergic Agents to Treat Depression” Drugs vol. 77,4 (2017): 381-401.
Zheng, W et al. “Rapid and longer-term antidepressant effects of repeated-dose intravenous ketamine for patients with unipolar and bipolar depression.” J Psychiatr Res. 2018 Nov;106:61-68. doi: 10.1016/j.jpsychires.2018.09.013. Epub 2018 Sep 25.
Anxiety disorders, the most prevalent psychiatric condition in American, are a persistent and often increasing state of worry or fear that interfere with activities of daily living, social interaction, and wellbeing. Generalized anxiety, panic disorder, and various phobia-related disorders are types of anxiety disorders.
Commonly, benzodiazepines and buspirone (anti-anxiety medications), antidepressants, and beta-blockers along with psychotherapy are used to treat anxiety disorders. It is estimated that 40% of patients with anxiety disorders are treatment resistant.
Taylor, Jerome H et al. “Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial” Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology vol. 43,2 (2017): 325-333.
Post-traumatic stress disorder (PTSD) is chronic or short-term development of reactionary symptoms as a result of trauma or situation. While the signs and symptoms are different for every person with PTSD, they involve event re-experiencing, avoiding thoughts or behaviors, trigger arousal and reactivity, and cognitive and mood changes.
Individuals suffering from PTSD are treated with antidepressant medications, psychotherapy, yet many individuals still experience severe symptom, reduced quality of life, and are at high risk for suicide.
After decades of treatment usage consideration, the San Francisco Veterans Affairs Medical Center is in its 2nd year of using ketamine for military veterans who suffer from post-traumatic stress disorder and depression. Ketamine has yielded successful and “impressive outcomes”.
Feder, Parides et al. “Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial.” JAMA Psychiatry. 2014 Jun;71(6):681-8.
Brachman, Rebecca A et al. “Ketamine as a Prophylactic Against Stress-Induced Depressive-like Behavior” Biological psychiatry vol. 79,9 (2015): 776-86
Obsessive-Compulsive Disorder (OCD) is a common, chronic mental health condition in which a person experiences uncontrollable, reoccurring thoughts and behaviors. Obsessive urges or distressing mental imagery, such as fear of germs or need for symmetry are alleviated with compulsions or repetitive, response behaviors. Excessive handwashing, arranging items in precise way, checking rituals, and counting are common compulsions.
Many individuals with OCD continue to experience symptoms despite a combination of traditional medication therapies that includes serotonin reuptake inhibitors (SRIS) and selective serotonin reuptake inhibitors (SSRIs), and psychotherapy. In addition to residual symptoms, it is common for patients to experience high rates of relapse.
Preliminary data from multiple research trials support the usage of ketamine is select OCD patients. Ketamine is a promising non-invasive, safe, and well-tolerated treatment option for OCD.
Rodriguez, Carolyn I et al. “Rapid resolution of obsessions after an infusion of intravenous ketamine in a patient with treatment-resistant obsessive-compulsive disorder” Journal of clinical psychiatry vol. 72,4 (2011): 567-9.
Hyperalgesia and allodynia are two types of pain that are atypical, yet incredibly debilitating.
Hyperalgesia is pain amplification—basically turning up the volume of pain. When they detect pain signals, the nerves send more signals than they should, and the brain over-responds to the input.
Allodynia is pain derived from a stimulus that usually shouldn’t cause any pain at all. It may include a light touch, fabric brushing against the skin, or moderate temperature.
Patil S, Anitescu M. “Efficacy of outpatient ketamine infusions in refractory chronic pain syndromes: a 5-year retrospective analysis. Pain Medicine. 2012 Feb;13(2):263-9.
Lauritsen, Clinton et al. “Intravenous ketamine for subacute treatment of refractory chronic migraine: a case series” journal of headache and pain vol. 17,1 (2016): 106.
Pomeroy, J. L., Marmura, M. J., Nahas, S. J. and Viscusi, E. R. (2017), Ketamine Infusions for Treatment Refractory Headache. Headache, 57: 276-282. doi:10.1111/head.13013
Correll, Maleki et al. “Subanesthetic ketamine infusion therapy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome.” Pain Medicine. 2004 Sep;5(3):263-75.
