According to a new study IM ketamine has been successful in treating psychiatric patients with multiple mental disorders not limited to depression. There has been significant improvement in the Average depression and anxiety levels which did not regress to baseline during the maintenance phase. The study was published in the journal BMC Psychiatry.
Ketamine is a general anesthetic that has emerged as a promising medication for managing depression and other mental illnesses. Intramuscular (IM) administration of ketamine is presently used at many North American outpatient psychiatric clinics due to its psychopharmacotherapeutic efficacy. Literature shows that the outpatient population receiving IM ketamine treatment showed better results but an evaluation of the real-world depression, anxiety, and safety outcomes of long-term psychiatric IM ketamine treatment has not been done. Hence researchers conducted a study to evaluate the clinical characteristics, treatment patterns, clinical outcomes, and adverse events of patients receiving IM ketamine treatment from January 2018 to June 2021.
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Patient data from the electronic health records of a private outpatient psychiatric clinic network in the United States were collected and analyzed retrospectively. Adults with any psychiatric diagnosis who received ketamine treatment only by IM administration were included. A total of 452 patients were included in the cohort.
Results
Patients receiving IM ketamine treatment had a mean of 2.8 psychiatric diagnoses.
420 (93%) patients had a diagnosis of major depressive disorder, 243 (54%) patients had a diagnosis of generalized anxiety disorder, and 126 (28%) patients had a diagnosis of post-traumatic stress disorder.
Patients received a median of 4 IM ketamine treatments.
Median depression scores (PHQ-9) improved by 38% from 16.0 at baseline to 10.0 at the last treatment.
Median anxiety scores (GAD-7) improved by 50% from 14.0 at baseline to 7.0 at the last treatment.
With maintenance ketamine treatments, average improvements in depression (PHQ-9) and anxiety (GAD-7) scores of at least 4.7 and 4.9 points were maintained for over 7 months.
An adverse event occurred during 59 of 2532 treatments (2.3%).
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Key Takeaways
The levels of depression and anxiety decreased following an intramuscular (IM) injection of ketamine.
Putting it into practice
Ketamine is a glutamatergic n-methyl-D-aspartate receptor antagonist that can be administered via the following routes: intravenous; intranasal; oral; sub-lingual; subcutaneous; and IM. Although the full spectrum of efficacy of IM ketamine has not been demonstrated, it has been shown that IM ketamine is safe and effective in treating outpatients with complex psychiatric histories.
Further Reading:
Ahuja, S., Brendle, M., Smart, L. et al. Real-world depression, anxiety and safety outcomes of intramuscular ketamine treatment: a retrospective descriptive cohort study. BMC Psychiatry 22, 634 (2022). https://doi.org/10.1186/s12888-022-04268-5