Ketamine Treatment for Refractory Anxiety: A Systematic Review

Course overview

Course Description: This course is based on material published in the British Journal of Clinical Pharmacology and is available as an open-access article. There is a growing interest in the psychiatric properties of the dissociative anaesthetic ketamine, as single doses have been shown to have fast-acting mood-enhancing and anxiolytic effects, which persist for up to a week after the main psychoactive symptoms have diminished. Therefore, ketamine poses potential beneficial effects in patients with refractory anxiety disorders, where other conventional anxiolytics have been ineffective. Ketamine is a noncompetitive antagonist of the N-methyl-D-aspartate (NMDA) glutamate receptor, which underlies its induction of pain relief and anesthesia. However, the role of NMDA receptors in anxiety reduction is still relatively unknown. To fill this paucity in the literature, this systematic review assesses the evidence that ketamine significantly reduces refractory anxiety and discusses to what extent this may be mediated by NMDA receptor antagonism and other receptors. We highlight the temporary nature of the anxiolytic effects and discuss the high discrepancy among the study designs regarding many fundamental factors such as administration routes, complementary treatments, and other treatments. This course on the use of ketamine as a treatment for anxiety is designed for social workers, professional counselors, psychologists, nurses, and substance abuse counselors who do clinical work. In addition, this course is appropriate for intermediate and advanced-level practitioners who wish to develop their knowledge of the use of ketamine as a treatment for anxiety. The course material includes a literature review of interventions and research. It may also be useful for licensed clinicians who require continuing clinical education courses for license renewal. The course is based on a journal article that includes research. It contains statistical analysis and data that some clinicians enjoy reading, and others do not. A significant benefit of reading research-based articles for continuing education is they provide practitioners with the latest findings in their field. Authors: Tully, Dahlén, Haggarty, Schioth, Brooks Learning Objectives: This course will provide the practitioner with detailed information regarding the use of ketamine as a treatment for anxiety. Specifically, a professional will: Identify mechanisms of action of ketamine and the neurobiological changes that occur in refractory anxiety. Describe differences in anxiety symptom outcomes of various dosages of ketamine. Recognize the relationship between ketamine and refractory anxiety. Citation: Tully, J. L., Dahlen, A. D., Haggarty, C. J., Schioth, H. B., & Brooks, S. (2022). Ketamine treatment for refractory anxiety: A systematic review. British journal of clinical pharmacology, 88(10), 4412-4426. https://doi.org/10.1111/bcp.15374