Non-parenteral Ketamine for Depression: A Practical Discussion on Addiction Potential and Recommendations for Judicious Prescribing
CNS Drugs February 14, 2022 Jennifer Swainson, L. Klassen, Stefan Brennan et al. 42 citations
Intravenous ketamine and intranasal esketamine are used for depression but face cost and access barriers. Non-parenteral racemic ketamine (oral, sublingual, intranasal) might improve access, though evidence is limited. Concerns about ketamine's addictive potential have not been examined against available evidence. The authors argue that ketamine misuse risks are similar to those of stimulants or benzodiazepines, and prescribing should balance patient access with misuse concerns. A consortium of mood disorder specialists considers non-parenteral ketamine a reasonable option for select treatment-resistant depression cases and provides practical prescribing recommendations.