KETAMINE

WHAT IS KETAMINE – Ketamine for depression

Ketamine for depression is a dissociative anesthetic used medically for induction and maintenance of anesthesia. It is also used as a recreational drug. It is one of the safest anesthetics, as, in contrast with opiates, ether, and propofol, it suppresses neither respiration nor heart rate. Ketamine is a novel compound, derived from PCP, created in pursuit of a safer anesthetic with similar characteristics. Ketamine is also used for acute pain management.[19] [20]

At anesthetic doses, ketamine induces a state of “dissociative anesthesia”, a trance-like state providing pain relief, sedation, and amnesia.[21] The distinguishing features of ketamine anesthesia are preserved breathing and airway reflexes, stimulated heart function with increased blood pressure, and moderate bronchodilation.[21] At lower, sub-anesthetic doses, ketamine is a promising agent for pain and treatment-resistant depression.[22] However, the antidepressant action of a single administration of ketamine wanes with time. The long-term effects of repeated use are largely unknown, and are an area of active investigation.[23][24][25]

KETAMINE FOR DEPRESSION

See also: Esketamine § Depression
Ketamine is a robust and rapid-acting[54] antidepressant, although its effect is transient.[55] Intravenous ketamine infusion in treatment resistant depression may result in improved mood within 4 hours reaching the peak at 24 hours.[22][23] A single dose of intravenous ketamine has been shown to result in a response rate greater than 60% as early as 4.5 hours after the dose (with a sustained effect after 24 hours) and greater than 40% after 7 days.[56] Although there are only a few pilot studies studying the optimal dose, increasing evidence suggests that 0.5 mg/kg dose injected over 40 minutes gives an optimal outcome.[57] The antidepressant effect of ketamine is diminished at 7 days, and most people relapse within 10 days, although for a significant minority the improvement may last 30 days and longer.[23][24][56][58] One of the main challenges with ketamine treatment can be the length of time that the antidepressant effects lasts after finishing a course of treatment. A possible option may be maintenance therapy with ketamine which usually runs twice a week to once in two weeks.[23][24][25] Ketamine may decrease suicidal thoughts for up to three days after the injection.[59]

KETAMINE FOR PAIN

Ketamine infusions are used for acute pain treatment in emergency departments and in the perioperative period in individuals with refractory pain. The doses are lower than those used for anesthesia; they are usually referred to as sub-anesthetic doses. Adjunctive to morphine or on its own, ketamine reduces morphine use, pain level, nausea, and vomiting after surgery. Ketamine is likely to be most beneficial for surgical patients when severe post-operative pain is expected and for opioid-tolerant patients.[46] And for people wanting to buy ketamine online click here for more details[47]

Ketamine is especially useful in the prehospital setting, due to its effectiveness and low risk of respiratory depression.[48] Ketamine has similar efficacy to opioids in a hospital emergency department setting for management of acute pain and for control of procedural pain.[49] It may also prevent opioid-induced hyperalgesia[50][51] and postanesthetic shivering.[52]