Ketamine is safe for patients with eating disorders who also have treatment-resistant depression or bipolar depression, even when medical or nutritional instability is present due to disordered eating. A retrospective analysis of 104 patients receiving higher levels of care for their eating disorder found no safety concerns with ketamine treatment. The findings indicate that ketamine can be used with medical monitoring in this challenging population, despite the complications of malnutrition and other behaviors that often accompany eating disorders.
Adults with eating disorders (EDs) who also have treatment-resistant depression or bipolar disorder improved in depression, anxiety, suicidal ideation, and ED symptoms regardless of whether they received subanesthetic intranasal ketamine. In a matched comparison of 85 patients who received ketamine and 85 who did not, both groups showed significant improvements from admission to discharge on all outcomes, with no significant differences between groups. Ketamine-treated patients had significantly longer lengths of stay. The findings suggest ketamine may be a viable option for this population, but its efficacy for treating EDs with comorbid depression was not superior to standard care in this study.