A survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression: A preliminary evaluation of real world addictive potential
Ketamine has gained rapid popularity as a treatment option for treatment resistant depression (TRD). Though seen only in limited contexts, ketamine is a potential drug of abuse, addiction and diversion. Clinical ketamine studies to date have not systematically evaluated factors relevant to addiction...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1016439/full |
| _version_ | 1811224839406485504 |
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| author | Brittany Chubbs Jay Wang Shaina Archer Carson Chrenek Atul Khullar Michael Wolowyk Jennifer Swainson |
| author_facet | Brittany Chubbs Jay Wang Shaina Archer Carson Chrenek Atul Khullar Michael Wolowyk Jennifer Swainson |
| author_sort | Brittany Chubbs |
| collection | DOAJ |
| description | Ketamine has gained rapid popularity as a treatment option for treatment resistant depression (TRD). Though seen only in limited contexts, ketamine is a potential drug of abuse, addiction and diversion. Clinical ketamine studies to date have not systematically evaluated factors relevant to addiction risk in patients with TRD, but in treating patients with ketamine, risks of potential harms related to addiction must be considered. As clinical access to intravenous ketamine programs is limited in much of Canada, these considerations become even more important for clinicians who elect to offer patients less supervised, non-parenteral forms of ketamine treatment. This study explores factors relevant to addiction risk in a real-world sample of 33 patients with TRD currently or previously treated with sublingual (SL) or intranasal (IN) ketamine in the community. First, patients were surveyed using a Drug Liking and Craving Questionnaire (DLCQ) to assess their level of drug liking and craving for ketamine, and to screen for symptoms of a ketamine use disorder. Second, the pharmacy records of these patients were reviewed for red flags for addiction such as dose escalation or early refills. Third, surveys were administered to the treating psychiatrists of patients who had discontinued ketamine to determine if abuse concerns contributed to reason for discontinuation. Though limited to a small sample, results indicate that ketamine is not a universally liked or craved substance in patients with TRD. Prescribers of non-parenteral ketamine should monitor patients and prescribe cautiously. Factors related to addiction (as in the DLCQ) should be explored for clinicians to consider individual risk/benefit for judicious use of ketamine in patients with TRD. |
| first_indexed | 2024-04-12T08:55:54Z |
| format | Article |
| id | doaj.art-3eb537394e2b4195b557a3e4ca18f411 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-12T08:55:54Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-3eb537394e2b4195b557a3e4ca18f4112022-12-22T03:39:23ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-11-011310.3389/fpsyt.2022.10164391016439A survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression: A preliminary evaluation of real world addictive potentialBrittany Chubbs0Jay Wang1Shaina Archer2Carson Chrenek3Atul Khullar4Michael Wolowyk5Jennifer Swainson6Department of Psychiatry, University of Alberta, Edmonton, AB, CanadaDepartment of Psychiatry, University of British Columbia, Vancouver, BC, CanadaDepartment of Psychiatry, University of Alberta, Edmonton, AB, CanadaDepartment of Psychiatry, University of Alberta, Edmonton, AB, CanadaDepartment of Psychiatry, University of Alberta, Edmonton, AB, CanadaCrestwood Apothecary, Edmonton, AB, CanadaDepartment of Psychiatry, University of Alberta, Edmonton, AB, CanadaKetamine has gained rapid popularity as a treatment option for treatment resistant depression (TRD). Though seen only in limited contexts, ketamine is a potential drug of abuse, addiction and diversion. Clinical ketamine studies to date have not systematically evaluated factors relevant to addiction risk in patients with TRD, but in treating patients with ketamine, risks of potential harms related to addiction must be considered. As clinical access to intravenous ketamine programs is limited in much of Canada, these considerations become even more important for clinicians who elect to offer patients less supervised, non-parenteral forms of ketamine treatment. This study explores factors relevant to addiction risk in a real-world sample of 33 patients with TRD currently or previously treated with sublingual (SL) or intranasal (IN) ketamine in the community. First, patients were surveyed using a Drug Liking and Craving Questionnaire (DLCQ) to assess their level of drug liking and craving for ketamine, and to screen for symptoms of a ketamine use disorder. Second, the pharmacy records of these patients were reviewed for red flags for addiction such as dose escalation or early refills. Third, surveys were administered to the treating psychiatrists of patients who had discontinued ketamine to determine if abuse concerns contributed to reason for discontinuation. Though limited to a small sample, results indicate that ketamine is not a universally liked or craved substance in patients with TRD. Prescribers of non-parenteral ketamine should monitor patients and prescribe cautiously. Factors related to addiction (as in the DLCQ) should be explored for clinicians to consider individual risk/benefit for judicious use of ketamine in patients with TRD.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1016439/fullketamineintranasalsublingualtreatment resistant depression (TRD)addictionabuse |
| spellingShingle | Brittany Chubbs Jay Wang Shaina Archer Carson Chrenek Atul Khullar Michael Wolowyk Jennifer Swainson A survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression: A preliminary evaluation of real world addictive potential Frontiers in Psychiatry ketamine intranasal sublingual treatment resistant depression (TRD) addiction abuse |
| title | A survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression: A preliminary evaluation of real world addictive potential |
| title_full | A survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression: A preliminary evaluation of real world addictive potential |
| title_fullStr | A survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression: A preliminary evaluation of real world addictive potential |
| title_full_unstemmed | A survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression: A preliminary evaluation of real world addictive potential |
| title_short | A survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression: A preliminary evaluation of real world addictive potential |
| title_sort | survey of drug liking and cravings in patients using sublingual or intranasal ketamine for treatment resistant depression a preliminary evaluation of real world addictive potential |
| topic | ketamine intranasal sublingual treatment resistant depression (TRD) addiction abuse |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1016439/full |
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