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A Pain Physician and Anesthesiologist’s Perspective on Ketamine for Treatment-Resistant Depression

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Abstract

Ketamine has emerged as a potential treatment for refractory depression. The clinical use of ketamine, however, has historically been confined to the field of anesthesiology. The majority of ketamine for affective disorder research has targeted psychiatrists. Expanded use of ketamine therapy will involve anesthesiologists, who possess a comprehensive understanding of its pharmacology. In this article, we provide a synthesis of past and current literature to provide a framework of the pharmacology, mechanisms, and clinical considerations for patient safety in the use of ketamine therapy for treatment-resistant depression. We caution support of indefinite administration of ketamine for depression due to lack of data on safety and efficacy with chronic use.

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Authors and Affiliations

  1. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, 32224, USA

    Lauren E. Gatewood, George Barsoum & Steven B. Porter

  2. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Scottsdale, AZ, USA

    Andrew W. Gorlin & Christopher H. Bailey

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  1. Lauren E. Gatewood
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  2. Andrew W. Gorlin
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  3. Christopher H. Bailey
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  4. George Barsoum
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Contributions

Steven Porter: conceptualization, investigation, project administration, resources, supervision, roles/writing—original draft, and writing—review editing. Lauren Gatewood: investigation, resources, roles/writing—original draft, and writing—review editing. Christopher Bailey: conceptualization, investigation, roles/writing— original draft, and writing—review editing. Andrew Gorlin: conceptualization, investigation, roles/writing—original draft, and writing—review editing. George Barsoum: conceptualization, investigation, roles/writing—original draft, and writing—review editing. All authors contributed to the review of the literature and data analysis. Each contributed to the draft and/or critically revised the work. All authors read and approved the final manuscript.

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Correspondence to Steven B. Porter.

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Gatewood, L.E., Gorlin, A.W., Bailey, C.H. et al. A Pain Physician and Anesthesiologist’s Perspective on Ketamine for Treatment-Resistant Depression. SN Compr. Clin. Med. 5, 104 (2023). https://doi.org/10.1007/s42399-023-01439-7

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