Relationships between reduction in symptoms and restoration of function and wellbeing: outcomes of the Oral Ketamine Trial on Suicidality (OKTOS)

2021 ◽  
pp. 114212
Author(s):  
Denise Beaudequin ◽  
Adem T. Can ◽  
Monique Jones ◽  
Cian Yang ◽  
Jennifer K. Scherman ◽  
...  
Keyword(s):  
Oral Ketamine

scholarly journals Low dose oral ketamine treatment in chronic suicidality: An open-label pilot study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Adem T. Can ◽  
Daniel F. Hermens ◽  
Megan Dutton ◽  
Cyrana C. Gallay ◽  
Emma Jensen ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Low Dose ◽  
Suicide Ideation ◽  
Well Being ◽  
Primary Outcome Measure ◽  
Open Label ◽  
Oral Ketamine ◽  
High Level ◽  
Chronic Suicidality

AbstractRecently, low-dose ketamine has been proposed as a rapid-acting treatment option for suicidality. The majority of studies to date have utilised intravenous (IV) ketamine, however, this route of administration has limitations. On the other hand, oral ketamine can be administered in a range of settings, which is important in treating suicidality, although studies as to safety and feasibility are lacking. n = 32 adults (aged 22–72 years; 53% female) with chronic suicidal thoughts participated in the Oral Ketamine Trial on Suicidality (OKTOS), an open-label trial of sub-anaesthetic doses of oral ketamine over 6 weeks. Participants commenced with 0.5 mg/kg of ketamine, which was titrated to a maximum 3.0 mg/kg. Follow-up assessments occurred at 4 weeks after the final dose. The primary outcome measure was the Beck Scale for Suicide Ideation (BSS) and secondary measures included scales for suicidality and depressive symptoms, and measures of functioning and well-being. Mean BSS scores significantly reduced from a high level of suicidal ideation at the pre-ketamine (week 0) timepoint to below the clinical threshold at the post-ketamine (week 6) timepoint. The proportion of participants that achieved clinical improvement within the first 6 weeks was 69%, whereas 50% achieved a significant improvement by the follow-up (week 10) timepoint. Six weeks of oral ketamine treatment in participants with chronic suicidality led to significant reduction in suicidal ideation. The response observed in this study is consistent with IV ketamine trials, suggesting that oral administration is a feasible and tolerable alternative treatment for chronic suicidality.

scholarly journals A Randomised Controlled Trial on the Efficacy and Safety of Oral Ketamine in Neonatal Circumcision

2021 ◽  
Author(s):  
Victor Ifeanyichukwu Modekwe ◽  
Jideofor Okechukwu Ugwu ◽  
Okechukwu Hyginus Ekwunife ◽  
Andrew Nwankwo Osuigwe ◽  
Jideofor Chukwuma Orakwe ◽  
...  
Keyword(s):  
Placebo Group ◽  
Controlled Trial ◽  
Controlled Study ◽  
Categorical Variables ◽  
Paediatric Surgery ◽  
Peripheral Oxygen Saturation ◽  
Double Blind ◽  
Oral Ketamine ◽  
The Mean ◽  
Neonatal Circumcision

Introduction: Procedural analgesia use in neonatal circumcision is not widespread in the developing world. An easy-to-administer, adequate and safe analgesia will encourage usage in neonatal circumcision. Orally administered ketamine may prove effective and safe, and may encourage procedural analgesia use in neonatal circumcision. Aim: To determine the analgesic efficacy of oral ketamine in Plastibell® neonatal circumcision. Materials and Methods: A hospital based randomised double blind controlled study was conducted at the paediatric surgery unit of the hospital, from March 2015 to December 2015. Total 121 neonates were sequentially recruited, and randomised into two groups. Group A received oral ketamine, and Group B received plain syrup (placebo) as procedural analgesia. Continuous pulse oximeter monitoring was done before, during and immediately after the procedure. The pre-procedural and intra-procedural peripheral oxygen saturation (SpO2) and Pulse Rate (PR) were determined at the various stages. Also, the Neonatal Infant Pain Scale (NIPS) scores were assessed during the stages of the procedure. Differences in mean scores were analysed. Mann-Whitney U test and Independent t-test were used to compare means of continuous variable, while Fisher’s exact test was used to compare categorical variables. Significance was set at p<0.05. Results: Sixty-one neonates received oral ketamine, while 60 received placebo. The intraoperative mean SpO2 were lower in the placebo group and significant at the tying stage with p=0.022. The mean intraoperative PR was higher in the placebo group and significant at dorsal-slit, tying and excision stages (p<0.05). The mean intraoperative NIPS scores were significantly higher in the placebo group. Conclusion: Oral ketamine provides effective and safe analgesia for neonatal Plastibell® circumcision in comparison to placebo.

VOMITING

2018 ◽  
Vol 25 (12) ◽  
pp. 1887-1891
Author(s):  
Malik Jamil Ahmed ◽  
Muhammad Nasir ◽  
Aamir Furqan
Keyword(s):  
Computer Software ◽  
Outcome Variable ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Postoperative Vomiting ◽  
Hospital Data ◽  
Chi Square ◽  
Oral Ketamine ◽  
The Difference

Objectives: To investigate whether the addition of dexamethasone and chloropheniramine to oral ketamine premedication affects the incidence of postoperative vomiting. Study Design: Randomized control trail. Setting: Department of Anesthesia and Intensive Care Nishtar Hospital, Multan. Period: March 2016 to March 2017. Methodology: After obtaining ethical approval ethical and review board of hospital. Data was entered in a computer software SPSS version 23.1 and analyzed for possible variables. Continuous variables were presented as mean and standard deviation like age, weight, sedation time, anesthesia time, admission time and PACU time. Categorical variables were presented as gender, ASA statusand postoperative vomiting. Student test and chi square test was applied to see association of outcome variable. P value of 0.05 was taken as significant. Results: Overall, 100% (n=80) patients were included in this study, both genders. The study group was further divided into twoequal groups, 50% (n=40) in each, i.e. Group K (Ketamine) group and group KD (Ketamine-Dexamethasone). The main outcome variable of this study was postoperative vomiting. In this study, Postoperative vomiting observed in 35% (n=10) and 10% (n=4) patients, for group K and group KD respectively. The difference was statistically significant (p=0.007). Conclusion: Addition of dexamethasone and chloropheniramine with ketamine as premedication reduce the incidence of postoperative vomiting.

Oral Ketamine for Depression, 2

2019 ◽  
Vol 80 (2) ◽  
Author(s):  
Chittaranjan Andrade
Keyword(s):  
Oral Ketamine

Treatment of nonsuicidal self-injury disorder with oral ketamine

2019 ◽  
Vol 3 (3) ◽  
pp. 129
Author(s):  
BrigitteC Vanle ◽  
Mitchell Fuller ◽  
Gabriella Hangiandreou ◽  
Stuart Silverman
Keyword(s):  
Oral Ketamine ◽  
Self Injury ◽  
Nonsuicidal Self Injury

scholarly journals Randomized clinical trial on the efficacy of intranasal or oral ketamine-midazolam combinations compared to oral midazolam for outpatient pediatric sedation

PLoS ONE ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. e0213074 ◽  
Author(s):  
Joji Sado-Filho ◽  
Karolline Alves Viana ◽  
Patrícia Corrêa-Faria ◽  
Luciane Rezende Costa ◽  
Paulo Sucasas Costa
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Oral Ketamine ◽  
Oral Midazolam ◽  
Pediatric Sedation

Iatrogenic Oral Ketamine Overdose in Palliative Care

2021 ◽  
Vol 24 (1) ◽  
pp. 148-151
Author(s):  
Jennifer D. Dulin ◽  
Jennifer Hardcopf ◽  
Patrick J. Coyne
Keyword(s):  
Palliative Care ◽  
Oral Ketamine

scholarly journals Safety and efficacy of extended release ketamine tablets in patients with treatment-resistant depression and anxiety: open label pilot study

2020 ◽  
Vol 10 ◽  
pp. 204512532092247 ◽  
Author(s):  
Paul Glue ◽  
Natalie J. Medlicott ◽  
Shona Neehoff ◽  
Peter Surman ◽  
Fred Lam ◽  
...  
Keyword(s):  
Extended Release ◽  
Vital Signs ◽  
Oral Formulation ◽  
Depression And Anxiety ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Open Label ◽  
Oral Ketamine ◽  
Tolerability Data ◽  
Resistant Depression

Background: Ketamine’s defining side effects are dissociation and increased blood pressure/heart rate. An oral formulation with delayed absorption could minimize these effects. We recently reported safety and tolerability data for an extended release ketamine tablet in healthy volunteers. Methods: To assess safety, tolerability, efficacy, and pharmacokinetics of an extended release oral ketamine tablet in patients with treatment-resistant depression/anxiety. This was a multiple dose open-label flexible dose uncontrolled study in seven patients with treatment-resistant depression/anxiety, who had all previously demonstrated mood improvement to subcutaneous ketamine. Assessments included ratings of anxiety, depression and dissociation, safety and tolerability, and blood samples for ketamine pharmacokinetics and brain-derived neurotrophic factor (BDNF) concentrations. Results: Improvements in anxiety and depression ratings occurred gradually over 96 h; all patients had >50% improvements in mood ratings. Ketamine was safe and well tolerated, with no changes in vital signs, and a single brief report of dissociation. Ketamine may induce its own metabolism, as the ratio of norketamine to ketamine increased out to 96 h. Serum BDNF concentrations did not change during the study. Conclusion: Ketamine’s safety/tolerability may be improved with an extended release oral formulation. Onset of mood improvement is slightly delayed compared with parenteral dosing. These data support the further development of extended release ketamine tablets for treatment of resistant depression and anxiety disorders.

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