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.
Comparable studies
Other observational and cohort studies on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |
| Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... | 2017 | Observational cohort | n = 59 |
| Clinical Predictors of Ketamine Response in Treatment-Resistant Major Depression Treatment-resistant inpatients with DSM-IV-TR-diagnosed major depressive disorder or... | 2014 | Post hoc analysis of pooled data from four studies | n = 108 |
| An investigation of amino-acid neurotransmitters as potential predictors of clinical improvement to ketamine in depression Drug-free patients with major depressive disorder | 2011 | Observational cohort | n = 14 |
| Efficacy of ketamine therapy in the treatment of depression Drug-free/naïve men with severe depression, no history of psychotic disorder, head... | 2019 | Observational cohort | n = 25 |