Is ketamine safe for individuals in higher level of care treatment for eating disorders? Analysis of safety of subanesthetic ketamine in 104 patients

Eating disorders are among the most challenging and fatal mental illnesses and, due to the complication of medical instability caused by malnutrition or other disordered eating behaviors, pose unique treatment challenges for patients with co-occurring depression and mood disorders. Randomized control trials have demonstrated “rapid and robust antidepressant effects” of generic ketamine in individuals with treatment-resistant depression and bipolar depression. This paper assesses the medical safety of ketamine as a treatment for co-occurring treatment-resistant depression or bipolar depression in patients in higher levels of care for their eating disorders. A retrospective analysis was conducted on 104 patients receiving higher levels of care for their eating disorder and who had co-occurring treatment-resistant depression or bipolar disorder. Data on medical safety, particularly in the context of medical and nutritional instability, was collected and analyzed. The findings demonstrated that ketamine is a safe intervention for patients with eating disorders and co-occurring treatment-resistant depression or bipolar depression, even in cases where relative medical or nutritional instability was present due to disordered eating behaviors. This paper presents that ketamine can be used safely with medical monitoring in patents with co-occurring eating disorder and treatment-resistant depression or bipolar depression, despite the challenges posed by medical and nutritional instability in this patient population.