W05 - Practical Strategies to Integrate Ketamine in Psychiatric Practice
Friday, 23 October
11:15 – 12:45 (1.5 hrs)
Atul Khullar*, MSc, MD; Rejish Thomas, MD, MSc, FRCPC; Jennifer Swainson, MD
At the end of this session, participants will be able to: 1) Understand the risks, benefits and current evidence of ketamine use in psychiatry; 2) Review experience and data from two large scale hospital based IV ketamine programs; and 3) Discuss practical strategies to improve patient access to ketamine in current mental health care systems.
Evidence for efficacy of ketamine to treat depression has accumulated, yet an understanding of its place in psychiatry is unclear. This workshop will first provide a review of the current state of evidence for the safety and efficacy of the various modalities of ketamine. A practical overview of paradigms to potentially incorporate ketamine prescribing into clinical practice and overall mental health care delivery systems will be discussed. The protocol development and experience of two large IV ketamine programs will be also be reviewed. Experience with ongoing provincial guideline development will also illustrate potential system issues and access implications with delivering ketamine treatment. Examples of community delivery of sublingual and intranasal ketamine will be presented as an alternative potentially more accessible system of care. Patient selection, cautions, controversies, and future directions of ketamine treatment will also be outlined with case based examples throughout.
Matveychuk D, Thomas RK, Swainson J, et al. Ketamine as an antidepressant: overview of its mechanisms of action and potential predictive biomarkers. Submitted as invited review to "Therapeutic Advances in Psychopharmacology."
Domany Y, Bleich-Cohen M, Tarrasch R, et al. Repeated oral ketamine for out-patient treatment of resistant depression: randomised, double-blind, placebo-controlled, proof-of-concept study. Br J Psychiatry 2019;214(1):20–26.