Virtual Reality as an Adjunct to Ketamine Infusion Therapy Increases Patient Satisfaction in the Management of Chronic Pain and Depression: A Retrospective Pilot Study
Melissa C. Selinger, David M. Compton, Hamilton Morris, Timothy J. Canty
Journal of Behavioral and Brain Science 2023 DOI: 10.4236/jbbs.2023.1312016 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective case review Pilot study Peer reviewed |
|---|---|
| Population | Patients with chronic pain and major depressive disorder |
| Intervention | Ketamine infusion |
| Topics | Depression Ketamine Esketamine |
| Keywords | Tolerability Chronic pain Anhedonia Depression economics Mood Visual analogue scale Rating scale Physical therapy Adverse effect |
| Citations | 3 |
| Key findings | Pain scores improved significantly by the third treatment day, depression ratings improved after infusions and across sessions, and two-thirds of patients preferred virtual reality with their ketamine infusion. |
Abstract
The management of patients with concomitant chronic pain (CP) and Major Depressive Disorder (MDD) remains challenging for clinicians. Current chronic pharmacologic management is often unsuccessful, or has intolerable side effects to the patients. While not restricted to patients with chronic pain, these patients are often diagnosed with depression, presenting with symptoms such as poor mood, anhedonia, and altered cognitive processes. It is estimated that a substantial proportion of treated patients do not derive a substantive benefit from traditional pharmacological treatments for depression. The present study involved a retrospective review of cases, exploring the patient-reported satisfaction with and tolerability of a novel use of virtual reality (VR), coined KVR, as an adjunct to intravenous ketamine infusion therapies. Specifically, the ketamine-virtual reality protocol was employed as a potential adjunctive intervention for patients suffering from chronic pain and depression. Visual Analog Scores (VAS) associated with pain were significantly lower on the third than on the first assessment day. Montgomery-Åsberg Depression Rating Scale (MADRS) scores improved following infusion and across days (i.e., sessions). Lastly, 2/3 of patients preferred the use of VR with their ketamine infusion. The results are considered in terms of implementing prospective studies to examine whether the combination therapies have a synergistic benefit and the nature and magnitude of clinically meaningful treatment effects, if any.