Safety and tolerability of IV ketamine in adults with major depressive or bipolar disorder: results from the Canadian rapid treatment center of excellence.

Expert Opinion on Drug Safety
Nelson B RodriguesJoshua D Rosenblat

Abstract

Rigorous clinical trials suggest ketamine is safe and well-tolerated in patients with treatment-resistant depression (TRD). There is a paucity of data on the safety and tolerability of ketamine in community-based clinics treating patients with TRD. Retrospective data was analyzed from 203 patients with TRD who received repeat-dose IV ketamine. Safety was operationalized as hemodynamic changes. Tolerability was evaluated through the reporting of adverse events and dissociation symptom severity, as measured by the Clinician-Administered Dissociative States Scale. Ketamine was well-tolerated, with less than 5% of patients withdrawing due to tolerability concerns. Blood pressure significantly increased during infusion, with 44.3% meeting criteria for treatment-emergent hypertension (i.e., blood pressure ≥ 165/100 mmHg). 12% of patients exhibiting hypertension required pharmacological intervention. The most frequently reported adverse events included drowsiness (56.4%), dizziness (45.2%), dissociation (35.6%), and nausea (13.3%). Dissociation severity significantly attenuated after the first infusion, but plateaued for subsequent infusions. Intravenous ketamine was safe and well-tolerated. Hypertension was commonly observed and was ...Continue Reading

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Citations

Jan 23, 2021·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Orly LipsitzJoshua D Rosenblat
Mar 12, 2021·Journal of Psychiatric Research·Joshua D Di VincenzoJoshua D Rosenblat
May 1, 2021·Advances in Therapy·Eric P McMullenRoger S McIntyre
Aug 24, 2021·Neuropsychiatric Disease and Treatment·Alina WilkowskaWiesław J Cubała

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