Ketamine for Pain Management, Treatment of Depression

Ketamine for Pain Management, Treatment of Depression – Linda Peckel – May 30, 2017

Ketamine may alleviate depression, pain, and side effects associated with opioid treatment, and may thus represent an attractive adjunct therapy for pain management, according to a novel population analysis recently published in Scientific Reports.

Nearly half of all patients with depression taking conventional antidepressants discontinue their treatment prematurely.

 Researchers have sought alternatives to standard antidepressants, for which therapeutic effects are delayed by 2 to 10 weeks.  

Ketamine, an N-methyl-D-aspartate antagonist, was shown to provide acute benefits for

• treatment-resistant depression,
• bipolar depression, and
• major depressive disorder with suicidal ideation,

when administered intravenously, however, those studies were conducted on limited samples (20 to 57 participants).

Researchers at the University of California San Diego, La Jolla, California therefore employed an Inverse-Frequency Analysis (IFA) approach to investigate whether ketamine – administered in addition to other therapeutics – has antidepressant properties

The team applied the IFA method, which looks for negative statistical patterns in the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) post-marketing database of > 8 million patient records.

They observed reductions in depression and pain in patients receiving ketamine, as indicated by negative log odds ratio (LogOR) values

According to Dr Abagyan, a study recently published by a British team indicates that ketamine might be effective in nearly 40% of patients with severe, treatment-resistant depression, results that are concordant with those from the current study.

The IFA method was also used to evaluate ketamine efficacy and associated side effects reported in the FAERS database.

The investigators found significant reductions in a number of side effects associated with opioid therapies, including

• constipation (LogOR −0.17 ± 0.023),
• vomiting (LogOR −0.16 ± 0.025), and
• nausea (LogOR −0.45 ± 0.034)

compared with other drug combinations used for pain management.

Conclusion

The authors concluded that their findings are in line with those from smaller studies, indicating beneficial effects for ketamine as a monotherapy or adjunctive therapy for depression, particularly treatment-resistant depression, with particular indication for patients with suicide ideation, due to its rapid onset of action.

References

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