Cardiovascular and Metabolic Comorbidities as the Factors for Adverse Events With Ketamine

Reply to Comments by Sadko and Jakuszkowiak

“…In consideration of the letter by Drs Sadko and Jakuszkowiak, 1 the increased risk of adverse events conferred by the presence of medical comorbidities does not seem to be borne out in the literature, unless a certain quantum of change in blood pressure or heart rate is considered an adverse event in itself. Although an increase in systolic blood pressure higher than 180 mm Hg may signal a risk, periodic increases in blood pressure and increases in heart rate greater than 100 beats per minute can be physiologic, whereas sustained increases in blood pressure or heart rate above these levels would be of concern.…”

“…With great interest, we read the letter by Drs Sadko and Jakuszkowiak 1 regarding risk assessment of patients with depression undergoing intravenous treatments with ketamine. Ketamine has a well-known risk profile during acute administration, but fewer safety data are available for chronically administered ketamine.…”