Ketamine: a new view on therapeutic opportunities in psychiatric practice

Abstract

This article is a review of evidence-based research in English for the past 15 years thanks to access via a database PubMed and Medline, about the new features out of claimed indications of the well-known short-acting anesthetic, ketamine. Latter being the antagonist of NMDA receptors by activating glutamatergic transmission has antidepressant effects. One intravenous infusion of 0.5 mg/kg of ketamine for 40 minutes can provide fast antidepressant effect, during the bipolar and monopolar resistant depression, especially with high risk of suicide. Instability of antidepressant effect of ketamine from a few hours to several weeks is demonstrated. It is also proved the effectiveness of ketamine in obsessive-compulsive and posttraumatic frustration. Intramuscular, oral and intranasal routes of applications are researched. Ketamin can probably serve as a therapeutic alternative in some patients with pharmacotherapy resistant depression except patients with substance abuse or a history of psychosis.