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Is ketamine safe for individuals in higher level of care treatment for eating disorders? Analysis of safety of subanesthetic ketamine in 104 patients.

Elizabeth Wassenaar, Dan V. Blalock, Alan Duffy, Megan Riddle, Howard Weeks, Phil Mehler, Renee D. Rienecke

Journal of Psychiatric Research August 1, 2025 DOI: 10.1016/j.jpsychires.2025.05.055 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Retrospective analysis Randomized Peer reviewed
Sample size 104
Population Patients receiving higher levels of care for their eating disorder with co-occurring treatment-resistant depression or bipolar depression
Intervention Ketamine
Topics Depression Ketamine Esketamine
Keywords Mental health research Antidepressive agents Malnutrition Mood disorders Ketamine therapy Eating disorders treatment Depression medication Psychiatric care
Citations 4
Key points Ketamine is a safe intervention for patients with eating disorders and co-occurring treatment-resistant depression or bipolar depression, even when relative medical or nutritional instability is present.

Abstract

Eating disorders are among the most challenging and fatal mental illnesses and, due to the complication of medical instability caused by malnutrition or other disordered eating behaviors, pose unique treatment challenges for patients with co-occurring depression and mood disorders. Randomized control trials have demonstrated "rapid and robust antidepressant effects" of generic ketamine in individuals with treatment-resistant depression and bipolar depression. This paper assesses the medical safety of ketamine as a treatment for co-occurring treatment-resistant depression or bipolar depression in patients in higher levels of care for their eating disorders. A retrospective analysis was conducted on 104 patients receiving higher levels of care for their eating disorder and who had co-occurring treatment-resistant depression or bipolar disorder. Data on medical safety, particularly in the context of medical and nutritional instability, was collected and analyzed. The findings demonstrated that ketamine is a safe intervention for patients with eating disorders and co-occurring treatment-resistant depression or bipolar depression, even in cases where relative medical or nutritional instability was present due to disordered eating behaviors. This paper presents that ketamine can be used safely with medical monitoring in patents with co-occurring eating disorder and treatment-resistant depression or bipolar depression, despite the challenges posed by medical and nutritional instability in this patient population.

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