Table 3. Summary of findings from case series.
Author(s) | n | Age (years) | Sex | Palliative care diagnosis | Intervention (dose, route, duration) | Depression measures | Results (depression) | Side effects | Comments and follow-up |
---|---|---|---|---|---|---|---|---|---|
Iglewicz52 | 31 | 44-89 | Both | Multiple (cancer and non-cancer) | Single (n=22) or multiple (n=9) doses of 0.5 mg/kg oral (n=29), SC (n=1) or oral + SC (n=1) ketamine | CGI score at baseline and days 0-1, 2-3, 4-7, and 8-21 | Positive therapeutic outcomes for depression were more common (93%) than negative therapeutic outcomes at days 0-1 (p < 0.001), 2-3 (p < 0.001), and 4-7 (p < 0.05) | No serious side effects More patients had positive therapeutic outcomes than negative therapeutic outcomes (p < 0.001 at days 0-1 and 8-21, and p < 0.05 at days 2-3 and 4-7) | |
Latuga53 | 3 | 76 | Male | Metastatic pancreatic adenocarcinoma | A single dose of SC ketamine (0.5 mg/kg) followed by repeated oral ketamine doses (daily, 0.5 mg/kg) | PHQ-4 | Reduction from PHQ-4 12 at baseline to PHQ-4 0 on day 7 | Somnolence, nausea, drowsiness, fatigue, sleepiness, feeling “strange” and “floating” Increased blood pressure at 20 min post-injection in one patient | Sustained remission with 0 on PHQ-4, died on day 50 |
83 | Male | End-stage alcoholic cirrhosis | Reduction on PHQ-4 from 6 at baseline to 1 on day 7 | PHQ-4 remained between 1 and 3, died on day 139 | |||||
49 | Female | Metastatic ovarian cancer | Reduction of PHQ-4 from 12 on day 3 to 1 on day 19 | Sustained until she died on day 37 | |||||
Rosenblat & Li54 | 3 | 67 | Female | Cancer | Repeated IM ketamine (three doses, 3 days interval, 50-150 mg) | Improved guilt, indecisiveness and strengthened desire for MAiD | Transient drowsiness and vivid dreams | ||
60 | Female | Ovarian cancer | Subjective “a lot better,” improved guilt and self-esteem, withdrew request for MAiD | Transient drowsiness and dizziness | |||||
80 | Male | Prostate cancer | Subjective improvement of depression, improved sleep Received MAiD |
Transient drowsiness and confusion |
CGI = Clinical Global Impression; IM = intramuscular; MAiD = medical assistance in dying; PHQ-4 = Patient Health Questionnaire; SC = subcutaneous.