A review of existing literature on ketamine use in people with dementia found only three case reports. One case used subcutaneous ketamine for depression, one used intramuscular ketamine for acute agitation, and one used S-ketamine as anesthesia during electroconvulsive therapy for depression and catatonia. No significant adverse effects were reported. The evidence remains limited, and high-quality prospective studies are needed before ketamine can be used to treat behavioral disturbances in dementia.
Ketamine, long used as an anesthetic, has been studied for psychiatric conditions, but evidence in older adults (age >60) is limited. This review of 14 randomized controlled trials and 2 post-hoc analyses found mixed results for ketamine in treating depression and delirium in this population. Five studies showed no significant effect on delirium incidence; two found lower incidence, but one found higher incidence with ketamine. Four studies showed improvement in depressive symptoms, while others did not. Side effects were mostly mild. The authors conclude that current data are insufficient for other psychiatric conditions in older adults, and use of ketamine requires individualized risk-benefit assessment through shared decision making.