Posted by ed_uk2010 on July 18, 2014, at 13:42:31
In reply to Re: Intranasal ketamine - Anyone? » Bob, posted by SLS on July 18, 2014, at 13:01:05
Hi Scott,
I didn't know you'd switched from nortriptyline to desipramine. I've not checked p-babble for a while though. Why did you change?
Intranasal ketamine doesn't sound as pleasant as oral. Ketamine is occasionally formulated as an oral solution for analgesia, mainly in palliative care. Psychotomimetic adverse effects, if they occur, are normally treated with benzodiazepines (not antipsychotics).
Would your psychiatrist give I/M ketamine? Low dose I/M ketamine is not especially unsafe eg. the risk of respiratory depression is extremely low, less than I/M benzos which are used very frequently in inpatient psychiatry. The main risk is a bad psychiatric reaction. And the drug may be difficult to obtain if it's not usually stocked by the hospital. If the hospital is part of a general/medical hospital they will probably stock ketamine for use in anesthesiology. Ketamine is not used in anesthesiology in the same way that it originally was. Low doses are used to augment analgesia and anesthesia produced by other drugs. High doses are not used on their own - the outcome of that was normally a lot of side effects!
There is currently a shortage of ketamine in the UK due to a production problem at Pfizer. Imported version from Germany are in use instead. This probably has no relevance to the US but I thought it was worth a mention.
poster:ed_uk2010
thread:1068237
URL: http://www.dr-bob.org/babble/20140717/msgs/1068490.html