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LITERATURE

Non‑parenteral Ketamine for Depression: A Practical Discussion on Addiction Potential and Recommendations for Judicious Prescribing


Intravenous (IV) ketamine is increasingly used off-label at subanesthetic doses for its rapid antidepressant effect, and intranasal
(IN) esketamine has been recently approved in several countries for treating depression. The clinical utility of these treatments
is limited by a paucity of publicly funded IV ketamine and IN esketamine programs and cost barriers to private treatment
programs, as well as the drug cost for IN esketamine itself, which makes generic ketamine alternatives an attractive option.
Though evidence is limited, use of non-parenteral racemic ketamine formulations (oral, sublingual, and IN) may offer more
realistic access in less rigidly supervised settings, both for acute and maintenance treatment in select cases. However, the psychiatric
literature has repeatedly cautioned on the addictive potential of ketamine and raised caution for both less supervised
and longer-term use of ketamine.


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Language
English
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NONE
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Specific Detail Info
CNS Drugs (2022) 36:239–251
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