Ketamines for Treatment Resistant Depression in Patients with Chronic Pain and Opioid Use

Clinical use of ketamine was evaluated in 3 patients (age 36, 55, and 72 years; 2 males, one female) who suffered not only from a chronic treatment resistant depression but also from severe chronic pain for which they were prescribed opiate analgesics that they no longer wished to use due to their fear of addiction. In all 3 cases, ketamine therapy has resolved the depression, markedly decreased pre-existing high anxiety, reduced the pain to more tolerable levels, and helped these patients to avoid opiates. One of these 3 patients was afflicted with partial paralysis of his left limbs by a stroke about 2 years prior to onset of ketamine therapy: he complained of muscular tension and stiffness in these limbs, especially in his left arm and left hand, with inability to use fingers of his left hand. His muscular difficulties are reduced when on ketamine. It is of much medical interest to extend ketamine studies to patients with cerebral palsy, particularly those who suffer from chronic depression.

Keywords: ketamine, chronic pain, opiates, treatment resistant depression, anxiety, cerebral palsy.