Intravenous ketamine for depression: A clinical discussion reconsidering best practices in acute hypertension management.
Ryan Yip, Jennifer Swainson, Atul Khullar, Roger S McIntyre, Kevin Skoblenick
Frontiers in psychiatry January 1, 2022 Peer reviewed DOI: 10.3389/fpsyt.2022.1017504 via PubMed
Summary
Ketamine infusions for treatment resistant depression can cause transient hypertension, necessitating careful blood pressure monitoring. Current guidelines recommend an aggressive response to these episodes, but this review suggests that these protocols should be updated to better align with best practices in hypertension management. By adopting revised guidelines, the administration of ketamine for depression could become safer and more accessible.
Study at a glance
| Design | review |
|---|---|
| Key finding | The approach to managing hypertensive episodes during ketamine infusions for depression should be updated to align with best practice guidelines. |
Abstract
Ketamine is a versatile medication with an emerging role for the treatment of numerous psychiatric conditions, including treatment resistant depression. Current psychiatry guidelines for its intravenous administration to treat depression recommend regular blood pressure monitoring and an aggressive approach to potential transient hypertensive episodes induced by ketamine infusions. While this approach is aimed at ensuring patient safety, it should be updated to align with best practice guidelines in the management of hypertension. This review defines and summarizes the currently recommended approach to the hypertensive emergency, the asymptomatic hypertensive urgency, and discusses their relevance to intravenous ketamine therapy. With an updated protocol informed by these best practice guidelines, ketamine treatment for depression may be more accessible to facilitate psychiatric treatment.