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

  • 实验方案

  • 发表日期：

    2025年

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  • Carson Chrenek,
  • Jennifer Swainson

摘要

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.