Key Considerations for Practical Administration of Ketamine in Severe Depression, and Its Use in Community Care in Edmonton, AB, Canada
Carson Chrenek, Jennifer Swainson
Ketamine January 1, 2025 Peer reviewed DOI: 10.1007/978-1-0716-4599-4_12 via Springer Nature
Summary
Intranasal esketamine and intravenous ketamine are effective treatments for treatment-resistant depression (TRD), but access is often hindered by cost and monitoring needs. The article reviews current literature on ketamine's pharmacologic use for TRD and discusses its implementation in Edmonton, AB, Canada. It highlights the importance of maintenance treatments, long-term safety monitoring, and alternative options to improve patient access while emphasizing careful prescribing outside of monitored settings.
Study at a glance
| Key finding | Patient access to intranasal esketamine and intravenous ketamine for treatment-resistant depression is limited due to cost and monitoring requirements. |
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Abstract
Although both intranasal esketamine and intravenous ketamine have proven efficacy and tolerability in treatment-resistant depression (TRD), patient access to these treatments is often limited due to cost, availability, and/or monitoring requirements. This article is intended to provide a synthesis of the current literature with regard to the pharmacologic use of ketamine in TRD and describe its application to clinical programming in Edmonton, AB, Canada. Topics discussed include rationale for maintenance ketamine treatments, monitoring of long-term safety concerns, and alternative options to intranasal esketamine and intravenous ketamine as creative solutions to improve patient access. Considerations for cautious and judicious prescribing of ketamine outside of highly monitored clinical settings are reviewed.