Ketamine for the Treatment of Depression in Patients Receiving Hospice Care: A Retrospective Medical Record Review of Thirty-One Cases
Open accessAbstract
Background Depression is prevalent in patients receiving hospice care. Standard antidepressant medications do not work rapidly enough in this setting. Evidence suggests that ketamine rapidly treats treatment refractory depression in the general population. Ketamine׳s role for treating depression in the hospice population warrants further study.Methods A retrospective medical record review of 31 inpatients receiving hospice care who received ketamine for depression on a clinical basis was conducted. The primary outcome measure was the Clinical Global Impression Scale, which was used retrospectively to rate subjects׳ therapeutic improvement, global improvement, and side effects from ketamine over 21 days. Additionally, time to onset of therapeutic effect was analyzed.Results Using the Clinical Global Impression Scale, ketamine was found to be significantly therapeutically effective through the first week after ketamine dosing (p < 0.05), with 93% of patients showing positive results for days 0-3 and 80% for days 4-7 following ketamine dosing. Patients experienced global improvement during all 4 studied time periods following ketamine dosing (p < 0.05). Significantly more patients had either no side effects or side effects that did not significantly impair functioning at each of the 4 assessed time periods following ketamine dosing (p < 0.05). Additionally, significantly more patients experienced their first therapeutic response during days 0-1 following ketamine dosing (p < 0.001) than during any other time period.Conclusions These data suggest that ketamine may be a safe, effective, and rapid treatment for clinical depression in patients receiving hospice care. Blinded, randomized, and controlled trials are required to substantiate these findings and support further clinical use of this medication in hospice settings.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In Iglewicz et al. (2015), the effect was maintained in 80% of patients after 4 to 7 days and in 60% after 8 days to 3 weeks.
“This effect was maintained in 80% of the patients after 4 to 7 days, and in 60% after 8 days to 3 weeks.”
From Psychedelics for the treatment of depression, anxiety, and existential distress in patients with a terminal illness: a systematic review (2022) · cites this paper as Iglewicz et al., 2015
In Iglewicz et al. (2015), 93% of depressed hospice patients had a positive effect on the Global Clinical Impression Scale in the first 3 days after the initial ketamine dose.
“In the first 3 days after the initial dose, 93% had a positive effect on the Global Clinical Impression Scale (GCI).”
From Psychedelics for the treatment of depression, anxiety, and existential distress in patients with a terminal illness: a systematic review (2022) · cites this paper as Iglewicz et al., 2015
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
1 retracted
Larkin, G. L., & Beautrais, A. L. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145711000629 · Cited by 254 · see citing works
Retracted(1976) · Medical Entomology and Zoology · Cited by 8,899 · see citing works
Molecular Mechanisms of Depression: Perspectives on New Treatment Strategies
Lang, U. E., & Borgwardt, S. (2013) · Cellular Physiology and Biochemistry · doi:10.1159/000350094 · Cited by 8,501 · see citing works
Goodman & Gilman's The Pharmacological Basis of Therapeutics
Brunton, L. L. (1985) · Cited by 7,321 · see citing works
Goodman and Gilman's the Pharmacological Basis of Therapeutics
Stigelman, W. H., & Pharm, D. (1986) · Military Medicine · doi:10.1093/milmed/151.1.386 · Cited by 6,796 · see citing works
Trivedi, M. H., Rush, A. J., Wisniewski, S. R., Nierenberg, A. A., Warden, D., Ritz, L., Norquist, G., Howland, R. H., Lebowitz, B., McGrath, P. J., et al. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.1.28 · Cited by 3,879 · cited 2× · see citing works
“Global improvement ratings on the CGI reflect improvement, whether or not the improvement is due entirely to the drug treatment and range from “very much improved” (score of 1) to “very much worse” (score of 7) with (1) very much improved; (2) much improved; (3) minimally improved; (4) no change; (5) minimally worse;…”
Antidepressant effects of ketamine in depressed patients
Berman, R. M., Cappiello, A., Anand, A., Oren, D. A., Heninger, G. R., Charney, D. S., & Krystal, J. H. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00230-9 · Cited by 3,856 · see citing works
A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression.
Zarate, C. A., Singh, J. B., Carlson, P. J., Brutsche, N. E., Ameli, R., Luckenbaugh, D. A., Charney, D. S., & Manji, H. K. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.8.856 · Cited by 3,766 · see citing works
mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA Antagonists
Li, N., Lee, B., Liu, R.-J., Banasr, M., Dwyer, J. M., Iwata, M., Li, X.-Y., Aghajanian, G., & Duman, R. S. (2010) · Science · doi:10.1126/science.1190287 · Cited by 2,881 · see citing works
Mental Health: New Understanding, New Hope
Brundtland, G. H. (2001) · JAMA · doi:10.1001/jama.286.19.2391 · Cited by 1,606 · see citing works
Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis
Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000146332.53619.b2 · Cited by 1,358 · cited 3× · see citing works
“The therapeutic effect reflects how much the condition has improved related to the study medication and ranges from “unchanged or worse” (score of 1) to “marked” improvement (score of 4) with (1) unchanged to worse; (2) minimal; (3) moderate; and (4) marked improvement.”
Murrough, J. W., Iosifescu, D. V., Chang, L. C., Al Jurdi, R. K., Green, C. E., Perez, A. M., Iqbal, S., Pillemer, S., Foulkes, A., Shah, A., et al. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13030392 · Cited by 1,205 · see citing works
Maeng, S., Zarate, C. A., Du, J., Schloesser, R. J., McCammon, J., Chen, G., & Manji, H. K. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.05.028 · Cited by 1,103 · see citing works
Depression as a predictor of disease progression and mortality in cancer patients: A Meta‐Analysis
Satin, J. R., Linden, W., & Phillips, M. J. (2009) · Cancer · doi:10.1002/cncr.24561 · Cited by 972 · see citing works
(2008) · Cited by 889 · see citing works
Zarate, C. A., Brutsche, N. E., Ibrahim, L., Franco-Chaves, J., Diazgranados, N., Cravchik, A., Selter, J., Marquardt, C. A., Liberty, V., & Luckenbaugh, D. A. (2012) · Biological Psychiatry · doi:10.1016/j.biopsych.2011.12.010 · Cited by 811 · see citing works
Murrough, J. W., Perez, A. M., Pillemer, S., Stern, J., Parides, M. K., aan het Rot, M., Collins, K. A., Mathew, S. J., Charney, D. S., & Iosifescu, D. V. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2012.06.022 · Cited by 786 · see citing works
Safety and Efficacy of Repeated-Dose Intravenous Ketamine for Treatment-Resistant Depression
aan het Rot, M., Collins, K. A., Murrough, J. W., Perez, A. M., Reich, D. L., Charney, D. S., & Mathew, S. J. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.08.038 · Cited by 690 · see citing works
Price, R. B., Nock, M. K., Charney, D. S., & Mathew, S. J. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.04.029 · Cited by 600 · see citing works
DiazGranados, N., Ibrahim, L. A., Brutsche, N. E., Ameli, R., Henter, I. D., Luckenbaugh, D. A., Machado-Vieira, R., & Zarate, C. A. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05327blu · Cited by 564 · see citing works
Ketamine as Adjuvant Analgesic to Opioids: A Quantitative and Qualitative Systematic Review
Subramaniam, K., Subramaniam, B., & Steinbrook, R. A. (2004) · Anesthesia & Analgesia · doi:10.1213/01.ane.0000118109.12855.07 · Cited by 504 · see citing works
Depression and anxiety disorders in palliative cancer care
Wilson, K. G., Chochinov, H. M., Graham Skirko, M., Allard, P., Chary, S., Gagnon, P. R., Macmillan, K., De Luca, M., O'Shea, F., Kuhl, D., et al. (2007) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2006.07.016 · Cited by 398 · see citing works
Panel, N. I. O. H. S.-O.-T.-S. (2003) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djg014 · Cited by 396 · see citing works
Panel, N. I. O. H. S.-O.-T.-S. (2004) · JNCI Monographs · doi:10.1093/jncimonographs/djg014 · Cited by 394 · see citing works
Depression, mortality, and medical morbidity in patients with coronary heart disease
Carney, R. M., & Freedland, K. E. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00111-2 · Cited by 378 · cited 3× · see citing works
“The therapeutic effect reflects how much the condition has improved related to the study medication and ranges from “unchanged or worse” (score of 1) to “marked” improvement (score of 4) with (1) unchanged to worse; (2) minimal; (3) moderate; and (4) marked improvement.”
Thase, M. E., Friedman, E. S., Biggs, M. M., Wisniewski, S. R., Trivedi, M. H., Luther, J. F., Fava, M., Nierenberg, A. A., McGrath, P. J., Warden, D., et al. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.5.739 · Cited by 332 · cited 2× · see citing works
“Global improvement ratings on the CGI reflect improvement, whether or not the improvement is due entirely to the drug treatment and range from “very much improved” (score of 1) to “very much worse” (score of 7) with (1) very much improved; (2) much improved; (3) minimally improved; (4) no change; (5) minimally worse;…”
Ibrahim, L., DiazGranados, N., Franco-Chaves, J., Brutsche, N., Henter, I. D., Kronstein, P., Moaddel, R., Wainer, I., Luckenbaugh, D. A., Manji, H. K., et al. (2012) · Neuropsychopharmacology · doi:10.1038/npp.2011.338 · Cited by 309 · see citing works
Analgesic Effect of Intravenous Ketamine in Cancer Patients on Morphine Therapy
Mercadante, S., Arcuri, E., Tirelli, W., & Casuccio, A. (2000) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(00)00194-9 · Cited by 264 · see citing works
Depression as a risk factor for mortality after acute myocardial infarction
Carney, R. M., Blumenthal, J. A., Catellier, D., Freedland, K. E., Berkman, L. F., Watkins, L. L., Czajkowski, S. M., Hayano, J., & Jaffe, A. S. (2003) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2003.08.007 · Cited by 249 · cited 3× · see citing works
“The therapeutic effect reflects how much the condition has improved related to the study medication and ranges from “unchanged or worse” (score of 1) to “marked” improvement (score of 4) with (1) unchanged to worse; (2) minimal; (3) moderate; and (4) marked improvement.”
Lauretti, G. R., Lima, I. C. P. R., dos Reis, M. P., Prado, W. A., & Pereira, N. L. (1999) · Anesthesiology · doi:10.1097/00000542-199906000-00005 · Cited by 222 · see citing works
Totally implantable venous-access ports: local problems and extravasation injury
Kurul, S., Saip, P. M., & Aydın, T. A. (2002) · The Lancet Oncology · doi:10.1016/s1470-2045(02)00905-1 · Cited by 216 · see citing works
Lee, H., Kim, S., Kim, J., Shin, I., Yang, S., & Yoon, J. (2005) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.668 · Cited by 205 · see citing works
Bruera, E. D., Driver, L., Barnes, E. A., Willey, J. S., Shen, L. F., Palmer, J. L., & Escalante, C. P. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.06.156 · Cited by 204 · see citing works
Handbook of psychiatry in palliative medicine.
Chochinov, H. M., & BREITBART, W. S. (2000) · Cited by 193 · see citing works
Carr, D. B., Goudas, L. C., Denman, W. T., Brookoff, D., Staats, P. S., Brennen, L., Green, G., Albin, R. D., Hamilton, D. A., Rogers, M. C., et al. (2004) · Pain · doi:10.1016/j.pain.2003.07.001 · Cited by 189 · see citing works
Small-Dose Ketamine Improves the Postoperative State of Depressed Patients
Kudoh, A., Takahira, Y., Katagai, H., & Takazawa, T. (2002) · Anesthesia & Analgesia · doi:10.1097/00000539-200207000-00020 · Cited by 189 · see citing works
Phelps, L. E., Brutsché, N. E., Moral, J. R., Luckenbaugh, D. A., Manji, H. K., & Zarate, C. A. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.09.029 · Cited by 188 · see citing works
Psychiatric Care of the Medical Patient
Fogel, B. S., & Greenberg, D. B. (2015) · Oxford University Press eBooks · doi:10.1093/med/9780199731855.001.0001 · Cited by 187 · see citing works
Ketamine as a Novel Antidepressant: From Synapse to Behavior
Murrough, J. W. (2012) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2011.244 · Cited by 172 · see citing works
Irwin, S. A., Iglewicz, A., Nelesen, R. A., Lo, J. Y., Carr, C. H., Romero, S. D., & Lloyd, L. S. (2013) · Journal of Palliative Medicine · doi:10.1089/jpm.2012.0617 · Cited by 167 · see citing works
Self-citationOral Ketamine as an Adjuvant to Oral Morphine for Neuropathic Pain in Cancer Patients
Kannan, T. R., Saxena, A., Bhatnagar, S., & Barry, A. (2002) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(01)00373-6 · Cited by 139 · see citing works
Oral Ketamine for the Rapid Treatment of Depression and Anxiety in Patients Receiving Hospice Care
Irwin, S. A., & Iglewicz, A. (2010) · Journal of Palliative Medicine · doi:10.1089/jpm.2010.9808 · Cited by 123 · see citing works
Self-citationMethylphenidate for depressive disorders in cancer patients
Fernandez, F., Adams, F., Holmes, V. F., Levy, J. K., & Neidhart, M. (1987) · Psychosomatics · doi:10.1016/s0033-3182(87)72476-1 · Cited by 117 · see citing works
Wallace, A. E., Kofoed, L., & West, A. N. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.6.929 · Cited by 115 · see citing works
Low-Dose Ketamine in the Management of Opioid Nonresponsive Terminal Cancer Pain
Fine, P. G. (1999) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(98)00144-4 · Cited by 114 · see citing works
Hardy, S. E. (2009) · The American Journal of Geriatric Pharmacotherapy · doi:10.1016/j.amjopharm.2009.02.006 · Cited by 107 · see citing works
A phase II study of methylphenidate for depression in advanced cancer
Homsi, J., Nelson, K. A., Sarhill, N., Rybicki, L. A., LeGrand, S. B., Davis, M. P., & Walsh, D. (2001) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/104990910101800610 · Cited by 104 · see citing works
Clark, J. L., & Kalan, G. E. (1995) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(95)00010-v · Cited by 103 · see citing works
Hypodermoclysis: an alternative infusion technique.
Sasson, M., & Shvartzman, P. (2001) · PubMed · Cited by 91 · see citing works
Macleod, A. D. (1998) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(98)00071-2 · Cited by 90 · see citing works
Low Dose Ketamine as an Analgesic Adjuvant in Difficult Pain Syndromes
Fitzgibbon, E., Hall, P., Schroder, C., Seely, J. F., & Viola, R. (2002) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(01)00393-1 · Cited by 83 · see citing works
Larkin, G. L., Beautrais, A. L., Turelli, R., Sanacora, G., Powsner, S. M., Lippmann, M. J., & Krystal, J. H. (2011) · European Psychiatry · doi:10.1016/s0924-9338(11)73311-9 · Cited by 80 · see citing works
Intravenous ketamine therapy in a patient with a treatment-resistant major depression
Liebrenz, M., Borgeat, A., & Leisinger, R. (2007) · Swiss Medical Weekly · doi:10.4414/smw.2007.11852 · Cited by 75 · see citing works
Effects of Methylphenidate in HIV-Related Depression: A Comparative Trial with Desipramine
Fernandez, F., Levy, J. K., Samley, H. R., Pirozzolo, F. J., Lachar, D., Crowley, J., Adams, S., Ross, B., & Ruiz, P. (1995) · The International Journal of Psychiatry in Medicine · doi:10.2190/16fh-9ect-y280-vv45 · Cited by 75 · see citing works
Correll, G. E., & Futter, G. E. (2006) · Pain Medicine · doi:10.1111/j.1526-4637.2006.00101.x · Cited by 73 · see citing works
Repeated intravenous ketamine therapy in a patient with treatment-resistant major depression
Liebrenz, M., Stohler, R., & Borgeat, A. (2008) · The World Journal of Biological Psychiatry · doi:10.1080/15622970701420481 · Cited by 73 · see citing works
Irwin, S. A., Pirrello, R. D., Hirst, J. M., Buckholz, G. T., & Ferris, F. D. (2013) · Journal of Palliative Medicine · doi:10.1089/jpm.2012.0319 · Cited by 71 · see citing works
Self-citationLong-Term Maintenance With Intramuscular Ketamine for Treatment-Resistant Bipolar II Depression
Cusin, C., Hilton, G. Q., Nierenberg, A. A., & D, M. F. M. (2012) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.12020219 · Cited by 70 · see citing works
Successful use of ketamine for intractable cancer pain
Lossignol, D., Obiols-Portis, M., & Body, J. (2004) · Supportive Care in Cancer · doi:10.1007/s00520-004-0684-4 · Cited by 69 · see citing works
Thrombotic Complications of Central Venous Catheters in Cancer Patients
Monreal, M., & Davant, E. (2001) · Acta Haematologica · doi:10.1159/000046591 · Cited by 64 · see citing works
Alternative Treatments of Breakthrough Pain in Patients Receiving Spinal Analgesics for Cancer Pain
Mercadante, S., Arcuri, E., Ferrera, P., Villari, P., & Mangione, S. (2005) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2005.04.014 · Cited by 62 · see citing works
Handbook of Psychiatry in Palliative Medicine
Hartshorn, M. A. (2001) · JAMA · doi:10.1001/jama.285.4.469 · Cited by 62 · see citing works
Intravenous Ketamine “Burst” for Refractory Depression in a Patient with Advanced Cancer
Stefanczyk-Sapieha, L., Oneschuk, D., & Demas, M. (2008) · Journal of Palliative Medicine · doi:10.1089/jpm.2008.9828 · Cited by 61 · see citing works
Brundtland, G. H. (2002) · JAMA · doi:10.1001/jama.287.9.1104 · Cited by 60 · see citing works
Ketamine and the potential role for rapid-acting antidepressant medications
Krystal, J. (2007) · Swiss Medical Weekly · doi:10.4414/smw.2007.11932 · Cited by 53 · see citing works
Diagnosis and Management of Depression in Palliative Care
Fairman, N. P., & Irwin, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/med/9780197583838.003.0004 · Cited by 50 · see citing works
Self-citationKing, D. A., Heisel, M. J., & Lyness, J. (2006) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.bpi029 · Cited by 41 · see citing works
Central Nervous System Stimulants as
Angrist, B., d’Hollosy, M., Sanfilipo, M. P., Satriano, J., Diamond, G. R., Simberkoff, M. S., & Weinreb, H. J. (1992) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199208000-00009 · Cited by 25 · see citing works
ANGRIST, B. M., d’Hollosy, M., Sanfilipo, M. P., Satriano, J., Diamond, G. W., Simberkoff, M. S., & Weinreb, H. J. (1992) · PubMed · Cited by 23 · see citing works
Psychiatric care of the medical patient
Chochinov, H. M. (1996) · General Hospital Psychiatry · doi:10.1016/0163-8343(96)90014-6 · Cited by 19 · see citing works
Physician-Reported Practice of the Use of Methylphenidate in Japanese Palliative Care Units
Matsuo, N., & Morita, T. (2007) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2007.02.025 · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [35]Zarate CA Jr Brutsche NE Ibrahim L Franco-Chaves J Diazgranados N Cravchik A Replication of ketamine’s antidepressant efficacy in bipolar depression: a randomized controlled add-on trial Biol Psychiatry 2012 71 11 939 46 22297150 PMC3343177
Cited by
Sorted by citations
Side-effects associated with ketamine use in depression: a systematic review
Short, B., Fong, J., Galvez, V., Shelker, W., & Loo, C. K. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30272-9 · Cited by 558 · see citing works
Ketamine use in current clinical practice
Gao, M., Rejaei, D., & Liu, H. (2016) · Acta Pharmacologica Sinica · doi:10.1038/aps.2016.5 · Cited by 286 · see citing works
Schimmers, N., Breeksema, J. J., Smith-Apeldoorn, S. Y., Veraart, J., van den Brink, W., & Schoevers, R. A. (2022) · Psychopharmacology · doi:10.1007/s00213-021-06027-y · Cited by 162 · see citing works
“(Iglewicz et al., 2015) retrospectively described the effects of ketamine (0.”
BackgroundKryst, J., Kawalec, P., Mitoraj, A. M., Pilc, A., Lasoń, W., & Brzostek, T. (2020) · Pharmacological Reports · doi:10.1007/s43440-020-00097-z · Cited by 159 · see citing works
Domany, Y., Bleich‐Cohen, M., Tarrasch, R., Meidan, R., Litvak-Lazar, O., Stoppleman, N., Schreiber, S., Bloch, M., Hendler, T., & Sharon, H. (2018) · The British Journal of Psychiatry · doi:10.1192/bjp.2018.196 · Cited by 114 · see citing works
The use of antidepressants in oncology: a review and practical tips for oncologists
Grassi, L. G., Nanni, M. G., Rodin, G., Li, M., & Caruso, R. (2017) · Annals of Oncology · doi:10.1093/annonc/mdx526 · Cited by 99 · see citing works
“A few non-controlled studies are available on the rapid response to ketamine in advanced cancer patients [33, 34] for acute depressive symptoms and suicidal ideation in newly diagnosed cancer patients [35].”
BackgroundByock, I. (2018) · Journal of Palliative Medicine · doi:10.1089/jpm.2017.0684 · Cited by 161 · see citing works
Oral ketamine for depression: An updated systematic review
Meshkat, S., Haikazian, S., Vincenzo, J. D. D., Fancy, F., Johnson, D. E., Chen-Li, D. C. J., McIntyre, R. S., Mansur, R. B., & Rosenblat, J. D. (2023) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2023.2169349 · Cited by 68 · see citing works
“…oral ketamine for depression (Irwin and Iglewicz 2010; Paslakis et al. 2010; McNulty and Hahn 2012; Lara et al. 2013; De Gioannis and De Leo 2014; Iglewicz et al. 2015; Nguyen et al. 2015; Swiatek et al. 2016; Al Shirawi et al. 2017; Hartberg et al. 2018; Latuga et al. 2021; Veraart et al. 2021;…”
BackgroundTop Ten Tips Palliative Care Clinicians Should Know About Psychopharmacology
Riordan, P. A., Briscoe, J. G., Uritsky, T. J., Jones, C. A., & Webb, J. A. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2019.0106 · Cited by 63 · see citing works
Gibson, A. W., & Graber, J. J. (2020) · Annals of Palliative Medicine · doi:10.21037/apm-20-509 · Cited by 57 · see citing works
“Some studies have also demonstrated the success of psychedelics and ketamine for treating cancerrelated psychiatric distress, particularly in hospice settings (184-186).”
BackgroundFalk, E., Schlieper, D., van Caster, P., Lutterbeck, M. J., Schwartz, J., Cordes, J., Grau, I., Kienbaum, P., & Neukirchen, M. (2020) · BMC Palliative Care · doi:10.1186/s12904-019-0499-1 · Cited by 57 · see citing works
Rosenblat, J. D., deVries, F. E., Doyle, Z., McIntyre, R. S., Rodin, G., Zimmermann, C., Mak, E., Hannon, B. L., Schulz-Quach, C., Al-Kindy, A., et al. (2023) · Cancers · doi:10.3390/cancers15020400 · Cited by 51 · see citing works
“Additionally, of note, the observed reduction in depressive symptoms was greater than reductions observed in previous studies using alternative routes of administration in this population (oral, SC, IM) [17,18,33].”
ResultDiagnosis and Management of Depression in Palliative Care
Fairman, N. P., & Irwin, S. A. (2022) · Oxford University Press eBooks · doi:10.1093/med/9780197583838.003.0004 · Cited by 50 · see citing works
Self-citationSubcutaneous Ketamine in Depression: A Systematic Review
Cavenaghi, V. B., da Costa, L. P., Lacerda, A. L. T., Hirata, E. S., Miguel, E. C., & Fráguas, R. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.513068 · Cited by 44 · see citing works
“The identified chart review (20) reported two patients (among a group of 31 patients) that received a single dose of SC racemic ketamine at 0.”
BackgroundThe Efficacy of Ketamine in the Palliative Care Setting: A Comprehensive Review of the Literature
Goldman, N., Frankenthaler, M., & Klepacz, L. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2018.0627 · Cited by 49 · see citing works
“18,19 A fading response of 6–7 days was also observed in a multiple-dose study in which repeat doses were given every 7–8 days.”
InfluentialEvidence-Based Management of Depression in Palliative Care: A Systematic Review
Perusinghe, M. A., Chen, K. Y., & McDERMOTT, B. M. (2021) · Journal of Palliative Medicine · doi:10.1089/jpm.2020.0659 · Cited by 40 · see citing works
“29 notedarapidresponse following use, as early as zero to one day.”
InfluentialNiles, H. F., Fogg, C., Kelmendi, B., & Lazenby, M. (2021) · BMC Palliative Care · doi:10.1186/s12904-021-00889-x · Cited by 39 · see citing works
Lucchese, A. C., Sarin, L. M., Magalhães, E. T. P., Sant, L. C. D., Puertas, C. B., Tuena, M. A., Nakahira, C., Fava, V. A. R., Delfino, R. S., Surjan, J. C., et al. (2021) · Journal of Psychopharmacology · doi:10.1177/0269881120978398 · Cited by 37 · see citing works
“Prior studies have shown that SC esketamine may be safe, feasible and effective along with standard antidepressant therapies under real-world conditions (George et al., 2017; Glue et al., 2017; Iglewicz et al., 2015; Loo et al., 2016).”
BackgroundDying on Hospice in the Midst of an Opioid Crisis: What Should We Do Now?
Gabbard, J., Jordan, A. E., Mitchell, J., Corbett, M., White, P., & Childers, J. W. (2018) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909118806664 · Cited by 27 · see citing works
Matsumoto, R. R., Nguyen, L., Weaver, C., Cramér, K., Pollard, S., & Marshalek, P. J. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s88569 · Cited by 26 · see citing works
Sant, L. C. D., Sarin, L. M., Magalhães, E. T. P., Lucchese, A. C., Tuena, M. A., Nakahira, C., Fava, V. A. R., Delfino, R. S., Surjan, J. C., Steglich, M. S., et al. (2020) · Journal of Psychopharmacology · doi:10.1177/0269881120922955 · Cited by 25 · see citing works
“…(s.c.) ketamine in TRD patients showed similar findings regarding its cardiovascular safety, despite these studies not being a head-to-head comparison of the safety of s.c. ketamine versus i.v. ketamine (Gálvez et al., 2014; George et al., 2017; Glue et al., 2017; Iglewicz et al., 2015).”
ResultDerntl, B., Hornung, J., Şen, Z. D., Čolić, L., Li, M., & Walter, M. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.00616 · Cited by 23 · see citing works
Johnson, R. J. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1651-9 · Cited by 17 · see citing works
Could ketamine be the answer to treating treatment‐resistant major depressive disorder?
Ramadan, A., & Mansour, I. (2020) · General Psychiatry · doi:10.1136/gpsych-2020-100227 · Cited by 15 · see citing works
A Case for Increased Medical Student and Psychiatric Resident Education in Palliative Care
Balon, R., Motlová, L. B., Beresin, E. V., Coverdale, J., Louie, A. K., & Roberts, L. W. (2015) · Academic Psychiatry · doi:10.1007/s40596-015-0479-6 · Cited by 15 · see citing works
Rodríguez-Mayoral, O., Pérez‐Esparza, R., Domínguez-Ocadio, G., & Allende‐Pérez, S. (2019) · Palliative & Supportive Care · doi:10.1017/s1478951519000580 · Cited by 14 · see citing works
“This effect is in accordance with previous reports in similar populations (Fan et al., 2017; Iglewicz et al., 2015).”
BackgroundResultSholevar, R., Kromka, W., & Beaussant, Y. (2025) · Journal of Palliative Medicine · doi:10.1089/jpm.2024.0346 · Cited by 12 · see citing works
Taylor, J. B., & Stern, T. A. (2017) · Psychosomatics · doi:10.1016/j.psym.2017.03.008 · Cited by 9 · see citing works
Núñez, N. A., Joseph, B., Pahwa, M., Seshadri, A., Prokop, L. J., Kung, S., Schak, K. M., Voort, J. L. V., Frye, M. A., & Singh, B. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4376 · Cited by 9 · see citing works
Oyetunji, A. O., Huelga, C., Bunte, K., Tao, R., & Bellman, V. (2023) · AIMS Public Health · doi:10.3934/publichealth.2023043 · Cited by 11 · see citing works
“However, before prescribing ketamine, it is important to consider its side effects such as dissociation, BP and HR changes, nausea and vomiting and headache and fatigue [41].”
BackgroundInfluentialLee, W., Sheehan, C., Chye, R., Chang, S., Bayes, A. J., Loo, C. K. A., Draper, B., Agar, M. R., & Currow, D. C. (2023) · PLoS ONE · doi:10.1371/journal.pone.0290876 · Cited by 8 · see citing works
Barbosa, M. G., Garcia, G. T., Sarin, L. M., & Jackowski, A. P. (2022) · Brazilian Journal of Psychiatry · doi:10.47626/1516-4446-2022-2876 · Cited by 9 · see citing works
Ferreira, A. E., & Reis-Pina, P. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.112020 · Cited by 6 · see citing works
Lee, W., Sheehan, C., Chye, R., Chang, S., Loo, C. K. A., Draper, B., Agar, M. R., & Currow, D. C. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-052312 · Cited by 6 · see citing works
Ketamine and Depression: A Review
Ryan, W. C., Marta, C. J., & Koek, R. J. (2014) · International Journal of Transpersonal Studies · doi:10.24972/ijts.2014.33.2.40 · Cited by 6 · see citing works
“…onset of antidepressant—in addition to analgesic—effects has been used with success is the inpatient palliative care setting (Prommer et al., 2012, Iglewicz et al., 2014), though concern has been raised that in the cancer patients, ketamine’s mTor upregulation could accelerate tumor growth…”
BackgroundInfluentialRajagukguk, S., & Lee, T. T. (2019) · Psychosomatics · doi:10.1016/j.psym.2019.09.005 · Cited by 5 · see citing works
Psychedelic therapy and cultural humility
Gearin, A. K., Docherty, J., Sun, X., Cheung, E. H.-L., & Tanuseputro, P. (2026) · Translational Psychiatry · doi:10.1038/s41398-026-03913-x · Cited by 4 · see citing works
“Concur-rently, psychedelic-like substances, such as ketamine or MDMA, are also showing promise in alleviating distress, depression, and pain in palliative care patients [15 – 18].”
Quigley, B. L., Can, A., Dutton, M., Gallay, C. C., Forsyth, G., Jones, M., Randall, F., Wilson, P. A., Lagopoulos, J., & Hermens, D. F. (2025) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2025.01.003 · Cited by 4 · see citing works
Luftnot, Jucken und Depression in der Palliativmedizin
Mücke, M., Conrad, R., Bleckwenn, M., Cuhls, H., Radbruch, L., & Rolke, R. (2016) · Der Schmerz · doi:10.1007/s00482-016-0104-y · Cited by 4 · see citing works
Campolina, A. G., & de Oliveira, M. A. T. (2025) · Healthcare · doi:10.3390/healthcare13212714 · Cited by 3 · see citing works
Algin, S., Banik, D., Rahman, S. A., Tusher, S. M., Johora, F. T., Akter, A., Ahmed, T., Biswas, M. A. M., Sinha, S., & Haque, M. (2024) · Cureus · doi:10.7759/cureus.57877 · Cited by 3 · see citing works
“Iglewicz et al. reported similarly that repeated administration of ketamine minimizes depression and normalized CGI score [89].”
BackgroundThe Interface Between Psychiatry and Palliative Medicine
Prabhakar, A., & MacLean, L. (2022) · Advances in Psychiatry and Behavioral Health · doi:10.1016/j.ypsc.2022.03.007 · Cited by 3 · see citing works
Nigam, K. B., Curseen, K. A., & Beaussant, Y. (2023) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2023.04.004 · Cited by 3 · see citing works
Kratina, S., Strıke, C., Schwartz, R. D., Nayfeh, A., Jopling, S. A., Lo, C., & Rush, B. R. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.118536 · Cited by 2 · see citing works
The Role of Ketamine in Depression #384
Christensen, A. R., & Pruskowski, J. A. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2019.0496 · Cited by 2 · see citing works
Arango-Posada, M. D. M., Prada-Escobar, A. I., Marín-Hernández, C., Monsalve-Franco, V., & Restrepo, D. (2022) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2022.03.001 · Cited by 1 · see citing works
“Irwin et al. 33 informaron de 2 casos de pacientes en un hos-picio, gravemente enfermos de otros problemas clínicos, que tuvieron una mejoría rápida y persistente de la depresión y la ansiedad tras la infusión de ketamina.”
Ketamine for Depression in Serious Illness: Evidence, Safety, and Practical Approaches
Noufi, P. E., Borris, J. B., Chammas, D., McDermott, C. L., Ufere, N. N., Webb, J. A., & Shalev, D. (2026) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2026.04.604 · Cited by 1 · see citing works
Robinson, J., Wallace, N., Cassidy, E. K., Lake, S., & Lucas, P. (2026) · Contemporary Drug Problems · doi:10.1177/00914509261444382 · Cited by 1 · see citing works
Simões, C., Julião, M., Calaveiras, P., Câmara, P., & Santos, T. (2024) · Palliative & Supportive Care · doi:10.1017/s1478951524000798 · Cited by 1 · see citing works
“While parenteral ketamine offers faster antidepressant effects (Goldman et al. 2019), oral administration emerges as a potentially more suitable option for palliative care patients, particularly those in hospice or home-based care who favor noninvasive treatments (Iglewicz et al. 2015).”
InfluentialOnderdonk, C., & Thornberry, K. (2019) · doi:10.1093/oso/9780190669607.003.0005 · Cited by 1 · see citing works
Le-Berre, R. (2020) · Dunod eBooks · doi:10.3917/dunod.centr.2020.01.0411
Traitements psychopharmacologiques
Razavi, D., Reich, M., Farvacques, C., Ronson, A., & Stefos, G. (2019) · Elsevier eBooks · doi:10.1016/b978-2-294-75811-9.00019-2
Pardo, S. G., Boada, L. B. G. L., & Lopez-Munoz, F. J. (2023) · Archivos de Medicina (Manizales) · doi:10.30554/archmed.23.1.4532.2023
Breeksema, J. J. (2024) · doi:10.33612/diss.912040905
Tiwari, A., Park, T., Parillon, B., Prather, S., Shalev, D., Reid, M. C., Czaja, S. J., Adelman, R. D., & Phongtankuel, V. (2024) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091241268578
Successful treatment for serious depression with suicidal risk in a heart transplant patient
Arango-Posada, M. D. M., Prada-Escobar, A. I., Marín-Hernández, C., Monsalve-Franco, V., & Restrepo, D. (2024) · Revista Colombiana de Psiquiatría (English ed ) · doi:10.1016/j.rcpeng.2022.03.001
Magoon, C., & Shalev, D. (2025) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2025.04.018
Prevalence Rate of Depression in Palliative and Hospice Care: A Narrative Review
Jacobs, R. M. (2025) · Journal of Social Work in End-of-Life & Palliative Care · doi:10.1080/15524256.2025.2601629
“…to treat depression, from psychotropic medications (e.g. SSRIs, tricyclics, psychostimulants) to talk therapies (e.g. cognitive behavioral therapy, mind-fulness-based cognitive therapy) to less common interventions (e.g. ketamine, reiki, etc.) (Dingley et al., 2021; Iglewicz et al., 2015).”
Horowitz, R. K., Rosa, W. E., Zarrabi, A. J., & Swogger, M. T. (2026) · Journal of Palliative Medicine · doi:10.1177/10966218251392787
Singhal, Y., Pavan Gaurav, R., Saji, S., Pingoliya, S. K., & Ghera, D. K. (2026) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.1080/15360288.2026.2679720
“Studies like those by Irwin et al (23) and Iglewicz et al (26) observed that oral ketamine had a slower onset of action but sustained antidepressant effects in hospice patients, albeit with some transient benefits.”
- Authors
- Iglewicz, A., Morrison, K., Nelesen, R. A., Zhan, T., Iglewicz, B., Fairman, N., Hirst, J. M., & Irwin, S. A.
- Affiliations
- University of California San Diego (US)
- University of Colorado Anschutz (US)
- Moores Cancer Center (US)
- Thomas Jefferson University (US)
- Temple University (US)
- University of California Davis Medical Center (US)
- Corresponding author
- Irwin, Scott A.
- Venue
- Psychosomatics
- Publisher
- Elsevier BV
- Published
- 2015-07
- Volume
- 56
- Issue
- 4
- Pages
- 329-337
- ISSN
- 0033-3182 (ISSN-L)
- PMC
- PMC4308579
- OpenAlex
- W2056645337
- Cited by
- 60
- References
- 71
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 6 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 8 · 2018: 4 · 2017: 3 · 2016: 2 · 2015: 2 · 2014: 1
- FWCI
- 1.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- The Medicine Forum (submittedVersion, cc-by-nc-nd)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Keywords
- ketamine, depression, hospice care, terminal illness, treatment-resistant depression, rapid antidepressant response, ketamine side effects, Clinical Global Impression Scale
- MeSH terms
- Adult, Aged, Aged, 80 and over, Depressive Disorder, Female, Humans, Ketamine, Male, Medical Records, Middle Aged, Retrospective Studies, Treatment Outcome, Hospice Care, Excitatory Amino Acid Antagonists
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
