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. 2022 Oct 24;3:1022767. doi: 10.3389/fpain.2022.1022767

Table 2.

Selected characteristics of case studies.

Author (year) Age (sex) Diagnosis Treatment protocol Findings Outcome measures Adverse effects
CDCP
 Barbosa et al. (56) 65 (male) Patient with cancer and MDD 0.5 mg/kg subcutaneous esketamine, twice weekly
  • 1. 

    Pain response was observed, but without stability.

  • 2. 

    Patient experienced a progressive relief of mood symptoms and achieved remission after the third dose.

 VAS (pain) MADRS (depression) Moderate dissociative symptoms and somnolence
 Bigman et al. (57) 47 (male) CDCP 0.5 mg/kg ketamine intramuscularly (single infusion)
  • 1. 

    Improvements in depression symptoms and pain levels lasting for 30 days post-infusion.

 PHQ9 (depression)
Subjective pain scores		 Not reported
 Hanna et al. (58) 31 (female) Chronic pain 10 days treatment with 200 mg/day of IV ketamine, increased progressively to 800 mg/day
  • 1. 

    Little improvements in the first 10 days. During the 1 month follow up, the pain scores and depression symptoms were drastically improved.

 VAS (pain)
GAD7
CESD-R (depression)		 No side effects were observed
 Mandyam and Ahuja (59) 30 (female) CDCP IV ketamine, infused cumulatively over the 3 days, 0.18 mg/kg/h increased progressively to 0.45 mg/kg/h
  • 1. 

    Within the first 2 days, improvements in pain reduction have been observed.

  • 2. 

    At 3 days after the start of treatment, manic symptoms were observed. Treatment was discontinued.

 Subjective pain scores
Depression assessed via psychiatric assessment
  • • 

    Visual hallucinations

  • • 

    Pressured speech

  • • 

    Delusions

  • • 

    Persistent psychotic thoughts

  • • 

    Euphoric mood
 McNulty and Hahn (60) 44 (male) CDCP and anxiety Single subcutaneous injection with 0.5 mg/kg ketamine, subsequently 40 mg/day of oral ketamine
  • 1. 

    Ketamine injection provided dramatic relief in depression symptoms and pain. These good outcomes could be sustained with the oral compound.

 Depression assessed via psychiatric assessment
Subjective pain scores		 Treatment was well-tolerated
 Mischel et al. (61) 81 (male) CDCP with anxiety and psychotic features 0.3–0.4 mg/kg/h of IV ketamine for 72 h
  • 1. 

    At 2 days after onset of the treatment, patient reported lack of suicide ideations and improvements in affect that lasted until 3 months follow-up.

 Depression assessed via psychiatric assessment
Pain measures not mentioned		 Not reported
77 (male) Severe depression and suicide attempt, resulting in bilateral orbit trauma 0.3–0.4 mg/kg/h of IV ketamine for 1 week
  • 1. 

    The patient reported reduction in pain levels. Affect and personal engagement improved significantly.

 Depression assessed via psychiatric assessment
Subjective pain scores		 Not reported
 Rodríguez-Mayoral et al. (63) 39 (female) Patient with cancer CDCP and suicide attempts Single injection of 0.5 mg/kg IV ketamine
  • 1. 

    Depression symptoms decreased by 17% on day 1, 39% on day 3 and 72% on day 17.

  • 2. 

    Suicidal ideation disappeared.

  • 3. 

    Pain was reduced.

 BEDS (depression)
ESAS (pain)		 Patient reported no side effects
 Sexton et al. (64) 64 (male) Patient with cancer and MDD 0.2 mg/kg/h of IV ketamine, for 26 h continuously
  • 1. 

    At 26 h after initiation of infusion, the patient achieved a pain score of 0/10 and mood was improved.

 PHQ9 (depression)
Subjective pain scores		 Not reported
 Stefanczyk-Sapieha et al. (65) 50 (male) Patient with cancer and MDD 0.5 mg/kg IV ketamine infusion, repeated after 10 days
  • 1. 

    Initial beneficial effects on depression symptoms and pain that started to wear off after 72 and 24 h post first and second infusion, respectively.

 BDI and HDRS (depression)
ESAS (pain)		 Single brief episode of a visual hallucination
 Weber et al. (66) 14 (female) Patient with depression, anxiety, and CRPS 0.12–0.56 mg/kg/h of IV ketamine for 6 days
  • 1. 

    Remarkable improvements in pain scores and depression symptoms. The beneficial effects could be sustained for 5 months.

 NRS (pain)
Depression assessed via psychiatric assessment		 Not reported
 Zanicotti et al. (67) 36 (female) Patient with cancer and MDD 1 mg/kg of intramuscular ketamine repeated, approximately weekly
  • 1. 

    Rapid onset of pain relief, with variable durability.

  • 2. 

    Improvement in depression symptoms that started to wear off after 6–7 days.

 CPS (pain)
MADRS and HADS (depression)		 Dissociative symptoms
CDAP
 Nichols et al. (62) 27 (male) Patient with severe buttock pain and opioid-induced depressive disorder 19 mg/kg IV ketamine, infused cumulatively over 4 days
  • 1. 

    Initial improvements in pain and mood. At day 4, patient started to show manic symptoms and treatment was discontinued.

 Subjective pain scores
Depression assessed via psychiatric assessment
  • • 

    Inappropriate sounds

  • • 

    Sexual hyperactivity

  • • 

    Delusional beliefs

  • • 

    Disinhibition

  • • 

    Diminished need for sleep

BDI, Beck Depression Inventory; BEDS, Brief Edinburgh Depression Scale; CDCP, Comorbid Depression Chronic Pain; CESD-R, Center for Epidemiologic Studies Depression-Revised; CPS, Comparative Pain Scale; CRPS, Complex Regional Pain Syndrome; ESAS, Edmonton Symptom Assessment System; GAD7, Generalized Anxiety Disorder (7 item-long); HADS, Hospital Anxiety and Depression Scale; HDRS, Hamilton Depression Rating Scale; IV, Intravenous; MADRS, Montgomery-Åsberg Depression Rating Scale; MDD, Major Depressive Disorder; NRS, Numerical Rating Scale; PHQ9, Patient Health Questionnaire (9 item-long); VAS, Visual Analog Scale.