Intranasal Ketamine for a Neuropsychiatric Condition

It decreases severity of migraine aura — could this formulation also be used for depression?

Researchers have begun examining the antidepressant effect of intravenous ketamine, an N-methyl-D-aspartate glutamate receptor antagonist and anesthetic (JW Psychiatry Jul 9 2012). Thus, research into potential additional therapeutic uses, especially with an easier-to-administer formulation, is of interest. This controlled, double-blind study examined the effect of intranasal ketamine in prolonged aura in migraine. The investigators hypothesized that cortical spreading depression — thought to be the basis of migraine auras — may have a glutamatergic basis and could be blocked by ketamine.

Twenty-nine patients with migraine and prolonged aura (range, 3 hours–1 week) were randomized to intranasal ketamine 25 mg or midazolam 2 mg. Participants …

Reviewing Author

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience