The role of ketamine and its enantiomer in managing depression and pain in cancer patients: A narrative review.

Ketamine and its enantiomer esketamine show promise for managing both depression and pain in cancer patients. Sub-anesthetic intravenous doses can alleviate postoperative depressive symptoms with a tolerable safety profile. Research on non-intravenous routes for depression in this population is limited. Intravenous ketamine is effective for acute postoperative pain, while alternative routes like local infiltration and intramuscular injection yield mixed results but may suit patients who avoid IV. Evidence for ketamine in chronic cancer pain is inconsistent. Overall, ketamine offers a promising approach for depression and pain in oncologic patients.

Study at a glance

Abstract

Depression and pain are common comorbidities in cancer patients, and ketamine, a dissociative anesthetic, has shown potential in managing both. This review summarizes current literature on ketamine and its enantiomer, esketamine, in managing depression and pain in the oncologic population. Studies indicate that sub-anesthetic doses of intravenous ketamine and esketamine can alleviate postoperative depressive symptoms in cancer patients with a tolerable safety profile. Research into non-intravenous routes for depression management in the oncologic population remains limited. Ketamine has also proven effective in managing acute postoperative pain, particularly through intravenous administration. While alternative administration routes, such as local infiltration and intramuscular methods, show mixed results, they may provide viable options for patients averse to intravenous (IV). However, the effectiveness of ketamine for chronic cancer pain remains inconsistent. Overall, ketamine offers a promising approach for managing depression and pain in oncologic patients.