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Key Considerations for Practical Administration of Ketamine in Severe Depression, and Its Use in Community Care in Edmonton, AB, Canada

Carson Chrenek, Jennifer Swainson

Ketamine 2025 DOI: 10.1007/978-1-0716-4599-4_12 (opens in new tab)

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AI-extracted from the abstract
Characteristics Review Peer reviewed
Topics Depression Esketamine Ketamine
Keywords Iv ketamine Community program Practical considerations Intranasal esketamine Sublingual ketamine At-home treatment
Key findings Creative alternatives to intranasal esketamine and intravenous ketamine, such as sublingual or at-home administration, may improve patient access to treatment for treatment-resistant depression.

Abstract

Although both intranasal esketamine and intravenous ketamine have proven efficacy and tolerability in treatment-resistant depression (TRD), patient access to these treatments is often limited due to cost, availability, and/or monitoring requirements. This article is intended to provide a synthesis of the current literature with regard to the pharmacologic use of ketamine in TRD and describe its application to clinical programming in Edmonton, AB, Canada. Topics discussed include rationale for maintenance ketamine treatments, monitoring of long-term safety concerns, and alternative options to intranasal esketamine and intravenous ketamine as creative solutions to improve patient access. Considerations for cautious and judicious prescribing of ketamine outside of highly monitored clinical settings are reviewed.

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