Ketamine is an anesthetic agent under investigation for off-label use as an antidepressant.
Oral doses have been administered as doses based on body weight or as fixed doses. Weight- based dosing has ranged from a low of 0.25 mg/kg to a high of 7 mg/kg per dosing occasion. Fixed doses have ranged from 25 mg to 300 mg per dosing occasion.
Oral ketamine has been administered as a one-off treatment, 2-3 times a day, once daily, thrice a week, and intermittently, as needed; it has been administered in a fixed course for 3-6 weeks and indefinitely for up to 3 years.
No studies compared different routes of ketamine administration directly
The benefits of Ketamine are not as pronounced or as sustained as those observed in patients treated with ECT. Treatment gains with single or repeated ketamine dosing have, so far, not been demonstrated to persist with maintenance pharmacotherapy with conventional antidepressants.
• Common adverse effects of ketamine in randomized trials included: dizziness, hallucinations, nausea, vomiting, drowsiness, confusion, light-headedness, headache, somnolence and anxiety
Other adverse effects
. Dissociation and psychotomimetic effects . Elevated blood pressure
. Increased pulse rate
. Chest pain, palpitations, and/or pressure . Euphoria
Longer-term, repeated use of ketamine can lead to:
– Abuse potential – Neurotoxicity
– Bladder toxicity – Hepatoxicity