This episode was originally published on February 12, 2019.
In this episode we interview Dr. Craig Heacock, our guest psychiatrist. We review using ketamine in the Emergency Department for depressed and suicidal patients.
The dose for ketamine for this indication is 0.5 mg/kg over infused 30-40 minutes.
Dr. Heacock recommends that you attempt to keep the room quiet. He even recommends eye shades and music if possible.
The patients that seem to have the best results are those with significant depressive symptoms. Dr. Heacock calls this “Black Bear Depression.” This is the depressed patient that has no energy, that has no desire to do anything, that wants to sleep all the time, that has no motivation to leave the house, that has difficulty finding the energy to go to work, etc.
Although the effect of ketamine in these patients can be profound, it is often in small ways. Examples of the benefits can be things such as having a desire to go to work, being able to walk the dog, the patient starts going to the gym, etc.
You should avoid ketamine in those patients that have a primary psychotic disorder. You can consider ketamine if they have had a drug related psychosis in the past and no recent drug use. Dr. Heacock uses ketaine in patients with PTSD, but he admits that this can be difficult in the Emergency Department because the hectic environment may trigger fear and anxiety in these patients.
If you are a physician, nurse practitioner, or physician assistant and going to claim CME credit, by downloading you acknowledge that you have read and understand the CME disclosures and information.
Download the episode here: Episode 17: Ketamine Revisited
Difficulty downloading? Right click (Mac users ctrl-click) then choose “Save link as…”
Click here to take the Quiz for CME (***Physicians, NPs, and PAs only***)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
