Ketamine infusion offers new hope for patients with dyskinesia and dystonia...

"I am always cautious when accrediting ketamine with new indications and am conscious of avoiding the 'snake oil label', says KetaMIND's founder and National Medical Director Dr Alan Howard. "However, the evidence for ketamine's benefit in levodopa induced dyskinesia (LID) cannot be ignored."

The FDA is poised to approve ketamine infusion therapy for LID. In a previous newsletter, we linked to 5-case reports in Case Rep Neurol in which an 'acute improvement in tremor' was noted in all patients, along with 'improvement in pain and depression'.

Prof Scott Sherman (professor of neurology at UACM) concludes that ketamine infusion therapy (KIT) offers a "novel non-surgical treatment for LID that will fill a major gap in the existing therapeutic arsenal.” He added that: "Ketamine is well-tolerated even in an older population of patients with advanced Parkinson’s disease."

It was found that after only 2-ketamine infusions, dyskinesia rating scores dropped by an average of 51% and after 3-months (without maintenance infusions) remained 41% lower than pre-treatment.

Read about a patient with cervical dystonia in whom dystonic symptoms were completely abolished within 30-seconds of an iv ketamine bolus, and who remained symptom free for 48-hours.

Read about a patient with cervical dystonia

KetaMIND Bedfordview- going from strength to strength...

Seen with our loyal nurses, Sheila Jacobs (centre) and Phyl Liquorish, is Jordan Stewart, the newly appointed Bedfordview Clinic administrator.

The 'jewel in the crown' of the KetaMIND group of clinics, our Bedfordview branch offers patients a state-of-the-art 4-cubicle clinic in this leafy Gauteng suburb. Established over 3-years ago, the clinic is now regularly open on Saturdays, which helps patients avoid interference of their working weeks.

We welcome Jordan Stewart, our new clinic administrator. Jordan brings a variety of business skills to the Bedfordview team.

KetaMIND's directors will soon have news to share about our new Sandton Clinic, and further expansion is planned in Gauteng in the near future.

Roelien Wiesner - a valuable addition to KetaMIND's Care Team...

Roelien brings a wealth of experience to the Care Team and her passion for counselling children battling trauma, depression and suicidal ideation will prove invaluable as we see more and more children and adolescents at our clinics.

Roelien built up two-decades' worth of experience in the DOJ Family Advocate's Office and National Prosecuting Authority before entering fulltime private practice. As a registered social worker and counsellor, her passion is helping children and adolescents dealing with trauma.

Roelien works closely with psychiatrists and psychologists and has been directly involved in counseling several children who have received ketamine infusions for depression and suicidality. These case studies were published in South African Psychiatry.

Consolidating a research and knowledge base...

Dr Alan Howard, KetaMIND's founder and National Medical Director has been responsible for researching and compiling the material shared in 24- KCSA newsletters to date. It is now planned to consolidate and index this body of work for ease of reference.

"KetaMIND's regular newsletters reach around 1400-professionals, and the 'unsubscribe' statistics are thankfully fairly low," says Dr Howard.

While the KetaMIND website has a comprehensive and categorized literature section, and all newsletters are published on the site, an indexing and search functionality will shortly be added.

As a member of the American ASKP3 and the Ketamine International Journal Club (KIJC) run out of Oxford, Dr Howard remains abreast of the latest ketamine research and publications and incorporates much of this information in the regular newsletters.

Anorexia Nervosa - can ketamine infusion help reduce relapses?

Published in the International Journal of Eating Disorders in August 2023, researchers in New York investigated the effect of ketamine in an animal model of anorexia nervosa.

Researchers from the Center for Neural Science and the NYU Neuroscience Institute in New York conclude that: 'ketamine may help adult females diagnosed with anorexia nervosa'.

It was found that sub-anaesthetic ketamine altered behaviour of mice experiencing activity-based anorexia (ABA). In females particularly, compensatory food consumption and weight retention improved after ketamine.

Link to the abstract

KetaMIND clinics currently offer outpatient ketamine infusions at the following locations:

BEDFORDVIEW (GP)

CONSTANTIA (WC)

UMHLANGA (KZN)

HILTON (KZN)

HILLCREST (KZN)

PAARL (WC)

Contact a KCSA clinic

In the next newsletter..

What works best? Intranasal esketamine or intravenous racemic ketamine?

The short answer is that both are effective. However, the preponderance of research to date suggests that racemic ketamine infusion holds the upper hand.

A recent study published in the Journal of Clinical Psychiatry concludes that the number of treatments required to achieve remission is 'significantly lower' with IV-ketamine. A meta-analysis of 1877-patients published in the Journal of Affective Disorders found iv-ketamine twice as effective in respect of response, remission and dropout rate.

Chirality does matter. In fact, researchers at King's College in the UK conclude that R-ketamine is a more potent and longer-lasting antidepressant than both racemic and S-ketamine.

We link to these articles in the next newsletter.

How did KCSA start in South Africa?

KetaMIND Clinics of South Africa (KCSA) was founded by Dr Alan Howard, a Consultant in Emergency Medicine who returned home permanently to his native South Africa from Ireland in 2019. Read more about Dr Howard and KCSA's flagship clinic in the Natal Midlands in two informative articles published in South African Psychiatry A follow-up article, Ketamine Clinics beyond the Hills can be accessed here.

Dr Howard is a member of the American Society of Ketamine Physicians (ASKP3), The Society of Sedation Practitioners of South Africa (SOSPOSA) and is an associate member of the South African Society of Psychiatrists (SASOP). He also serves on the KZN Advanced Trauma Life Support (ATLS) faculty. He founded the Society of Ketamine Practitioners of South Africa (SOKePSA) in 2020.

View past newsletters