Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review – CORRIGENDUM

Walsh, Zach; Mollaahmetoglu, O. Merve; Rootman, Joseph M.; Golsof, Shannon; Keeler, Johanna Louise; Marsh, Beth; Nutt, David; Morgan, Celia J. A.

doi:10.1192/bjo.2022.5

Cited by 15 publications

(3 citation statements)

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“…The phenomenon of opioid withdrawal involves adrenergic activation which could theoretically exacerbated by ketamine's indirect sympathomimetic effects 20 . However, ketamine may also attenuate physical withdrawal symptoms because of its interactions with recombinant mu and kappa receptors, ability to inhibit the reuptake of serotonin and dopamine, and its myriad psychological and psychomimetic effects which have demonstrated benefit for depression, anxiety, posttraumatic stress disorder, obsessive‐compulsive disorder, and substance use disorders, many of which share overlapping characteristics with withdrawal 20,21 . Its profound analgesic effects are also critical in providing adequate pain relief when opioids are contraindicated or impractical in the perioperative period.…”

Section: Discussionmentioning

confidence: 99%

The use of ketamine infusion to dramatically reduce opioid requirements in a patient whose high‐dose intrathecal opioid pump was inadvertently cut during surgery

et al. 2023

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BackgroundChronic opioid therapy may lead to high level tolerance development, hyperalgesia, and central sensitization, which further complicates long‐term therapeutic management of chronic pain patients. In this case, we encounter a patient who was receiving over 15,000 morphine milligram equivalents through their intrathecal pain pump. Unfortunately, the intrathecal pump was inadvertently cut during a spinal surgery. It was deemed unsafe to delivery IV equivalent opioid therapy in this case; instead, the patient was admitted to the ICU and given a four‐day ketamine infusion.MethodThe patient was started on a ketamine infusion at a rate of 0.5mg/kg/h, which was continued for three days. On the fourth day, the infusion rate was tapered over 12 h before being completely stopped. No coinciding opioid therapy was given during this time, which was only restarted in the outpatient setting.ResultsDespite chronic high levels of opioid therapy immediately prior to the ketamine infusion, the patient did not experience florid withdrawals during the infusion period. Additionally, the patient experienced remarkable improvement in their subjective pain rating, which decreased from 9 to 3–4 on an 11‐point Number Rating Scale, while simultaneously being managed on an MME <100. These results were sustained through a 6‐month follow‐up period.ConclusionKetamine may play an important role in attenuating not only tolerance but also acute withdrawal in a setting where rapid or instant weaning from high dose chronic opioid therapy is needed.

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Section: Discussionmentioning

confidence: 99%

The use of ketamine infusion to dramatically reduce opioid requirements in a patient whose high‐dose intrathecal opioid pump was inadvertently cut during surgery

et al. 2023

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“…I dag har ketamin vist effekt mot depresjon i over 20 dobbeltblindede, randomiserte, kontrollerte studier og flere metaanalyser, med responsog remisjonsrater på henholdsvis 70 % og 30 % innen 24 timer (Kvam et al, 2021). I kjølvannet av den tidligere forsk ningen på depresjon, har nyere kliniske studier vist lovende resultater i behandling av selvmordstanker, angstlidelser, posttraumatisk stresslidelse (PTSD), ruslidelser og spiseforstyrrelser (Walsh et al, 2022).…”

Section: Ketaminassistert Psykoterapiunclassified

Untitled

2023

TNPF

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Omslagsillustrasjon Johan Nord Form Bøk Oslo AS Trykk Aksell AS Siden 1973 har Tidsskrift for Norsk psykologforening vaert en viktig plattform for norsk psykologi. Vårt mål er å vaere en aktuell og faglig kvalitetssikret ressurs spesifikt rettet inn mot psykologers behov for informasjon, til deres praktiske profesjonsutøvelse og behov for oppdatering. Vi henvender oss også til andre som søker kunnskaper om psykologi, inkludert brukergrupper, politikere og journalister/media. Psykologtidsskriftet ønsker å stimulere til forsk ning og fagut vik ling og er et godkjent nivå-1-tidsskrift. I tillegg til vitenskapelige artikler finner du fagessay, reportasjer, bokanmeldelser, kronikker og debattinnlegg. Tidsskriftet skal speile psykologifagets innhold, utøvelse og plass i samfunnet. Les formålsparagrafen på www.psykologtidsskriftet.no Redaksjonen

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“…However, ketamine is a versatile tool which can be used in variety of ways ( 9 ). Here we articulate three paradigms for ketamine treatment: biochemical, psychotherapeutic, and psychedelic.…”

Section: Introductionmentioning

confidence: 99%

Ketamine for Bipolar Depression: Biochemical, Psychotherapeutic, and Psychedelic Approaches

Bennett¹,

Yavorsky²,

Bravo³

2022

Front. Psychiatry

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Bipolar disorder (type 1) is a serious and chronic psychiatric illness that can be difficult to treat. Many bipolar patients have refractory depressive episodes. Racemic ketamine, a glutamate modulator with prominent dissociate and psychedelic properties, has been demonstrated to have rapid acting antidepressant and anti-obsessional effects which may be useful for treating the symptoms of bipolar depression. Most of the existing research literature on unipolar and bipolar depression has looked at racemic ketamine in the sub-psychedelic dose range given by infusion as a stand-alone treatment (without concurrent psychotherapy). This article expands on the existing research by articulating three different paradigms for ketamine treatment: biochemical, psychotherapeutic, and psychedelic. The authors use composite clinical vignettes to illustrate different ways of working with ketamine to treat bipolar depression, and discuss a variety of clinical considerations for using ketamine with this population, including route, dose, frequency, chemical mitigators, and adverse events. Note that the conceptual paradigms could be applied to any ketamine treatment, with broad applicability beyond bipolar treatment.

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Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review – CORRIGENDUM

Cited by 15 publications

References 1 publication

The use of ketamine infusion to dramatically reduce opioid requirements in a patient whose high‐dose intrathecal opioid pump was inadvertently cut during surgery

The use of ketamine infusion to dramatically reduce opioid requirements in a patient whose high‐dose intrathecal opioid pump was inadvertently cut during surgery

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Ketamine for Bipolar Depression: Biochemical, Psychotherapeutic, and Psychedelic Approaches

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