Vice-Chair at University of Missouri - Columbia School of Medicine Department of Psychiatry (UMC SOM DOP); Associate Professor of Clinical Psychiatry; Medical Director for Interventional Psychiatry; and Associate Medical Director of Missouri University Psychiatric Center, Columbia, Missouri.
CAQ-Psychiatry, is a Clinical Instructor of Psychiatry and Director of Psychiatric Advanced Practice Provider Fellowships at UMC SOM DOP, Columbia, Missouri.
Mo Med. 2022 Mar-Apr;119(2):164-166.
Even though intravenous ketamine is not an FDA-approved depression treatment, multiple studies have shown a robust antidepressant effect which has led to an increase in clinical practices implementing its use to manage treatment-resistant depression. Traditionally, this therapy has been provided in both outpatient and inpatient settings, with anesthesia specialists and psychiatrists working collaboratively on most cases. Several studies have been conducted in various psychiatric settings to study the effects of ketamine in depression, mostly in a collaborative manner. Thorough search of the literature found no published reports on the use of ketamine infusions merely for clinical purposes in a psychiatric hospital setting, implemented solely by a psychiatric-based team without collaboration from anesthesia specialists. In an effort to explore the utilization of ketamine infusions, the Missouri University Psychiatric Center (MUPC), an acute mental inpatient facility, formed a ketamine infusion team composed solely of mental health clinicians and staff to investigate the use of ketamine infusions by a psychiatric team. To our knowledge, this is the first-time ketamine infusions have been administered by a clinically based psychiatric team in a psychiatric hospital. The MUPC ketamine team has proved that ketamine infusions may provide a unique intervention safely and efficaciously without the need for collaboration with other medical specialties since initiating this pilot program.
尽管静脉注射氯胺酮不是 FDA 批准的抑郁症治疗方法,但多项研究表明其具有强大的抗抑郁作用,这导致越来越多的临床实践开始采用氯胺酮来治疗难治性抑郁症。传统上,这种疗法既可以在门诊也可以在住院环境中提供,麻醉专家和精神科医生在大多数情况下合作开展治疗。在各种精神科环境中进行了多项研究来研究氯胺酮在抑郁症中的作用,主要是通过合作方式进行。彻底搜索文献发现,没有关于在精神病院环境中仅仅出于临床目的使用氯胺酮输注的报告,而且这些报告都是由精神科团队实施的,没有麻醉专家的合作。为了探索氯胺酮输注的应用,密苏里大学心理中心(MUPC)是一家急性精神科住院机构,组建了一支仅由心理健康临床医生和工作人员组成的氯胺酮输注团队,以调查精神科团队使用氯胺酮输注的情况。据我们所知,这是第一次由基于临床的精神科团队在精神病院中管理氯胺酮输注。自从启动这个试点项目以来,MUPC 的氯胺酮团队已经证明,氯胺酮输注可以安全有效地提供一种独特的干预措施,而无需与其他医学专业合作。