Ketamine and esketamine

Also known as Spravato · Esketamine nasal spray · Racemic ketamine depression · IV ketamine TRD · NMDA antagonist antidepressant

Exam-exhaustive fellowship reference on ketamine and esketamine for treatment-resistant depression — pharmacology, 0.5 mg/kg IV protocols, IN esketamine dosing and supervised observation, TRANSFORM/SUSTAIN/ASPIRE evidence, ELEKT-D vs ECT, dissociation and BP monitoring, abuse and bladder cautions, special populations. FRANZCP-primary, globally tagged.

high23 referencesUpdated 26 July 202612 min readVerification in progress

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10 MCQs

Meet the patient

A 44-year-old teacher, third depressive episode, eleven months unwell. Sertraline to 200 mg for ten weeks, then venlafaxine XR to 225 mg for nine weeks, both taken and both documented. No mania ever. No psychosis. She has stopped driving because she keeps thinking about the bridge on her commute.^[4]^[21]

Her GP has read about ketamine and wants to know why she cannot have it tomorrow. The examiner wants to know something narrower: what has to be true before you put this woman in a dosing chair?^[9]^[21]

References23Show

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