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Efecto antidepresivo de la Ketamina intranasal en el cuidado paliativo de pacientes con cáncer terminal

Secundino González Pardo, Lourdes González-Longoria Boada, Francisco Javier Lopez-Munoz

Archivos de Medicina September 4, 2023 DOI: 10.30554/archmed.23.1.4532.2023 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized, double-blind, placebo-controlled study Peer reviewed
Sample size 142
Population Patients with cancer and affective disorders
Intervention Ketamine
Dose 0.5 mg/kg ketamine; 1 mL placebo at 0.9%
Duration Administered every six hours for 3 days
Measures Montgomery-Åsberg Depression Rating Scale
Key points Intranasal ketamine at 0.5 mg/kg every six hours for 3 days significantly improved affective disorder scores in cancer patients (p < 0.001), while placebo produced nonsignificant improvement (p = 0.32). Nausea was the most common side effect in both groups.

Abstract

Background: patients with cancer are more likely to have affective disorders. Antide-pressant treatments take weeks to work. Evidence suggests that ketamine delivered by any route treats these symptoms, making it a recommendable option for oncologic patients what are they presenting depression, anxiety, and suicidal ideation. Material and

Methods: a randomized, double-blind, placebo-controlled study was conduc-ted in 142 participants with cancer. Ketamine at 0.5 mg / kg and 1m of placebo at 0.9% were administered intranasally every six hours for 3 days. The criterion used to evaluate efficacy was the total score on the Montgomery-Åsberg Depression rating scale. In addition, response time and adverse events to treatment were analyzed.

Results: the mean age was 69.11 ± 9.77 years. The most frequent carcinoma was the pancreatic head tumor (44.37%). Affective disorders improved significantly only in Group A (p <0.001). Group B presented improvements induced by the placebo effect, but no significant differences were found (p = 0.32). The main side effect was nausea in both cases.

Conclusions: ketamine administered intranasally is a safe, effective, and rapid therapy to reduce antidepressant effects and improve the quality of life of cancer patients. The response rate is similar to other studies. The adverse effects may limitation for its application.

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