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A new way to treat depression, anxiety and chronic neuropathic pain
Newsletter No 18 ( 31st January 2023)
"I don't believe my mind has ever been this healthy!"
"I planned to end my life after my 3rd infusion during December 2022".
Patient testimonials remain the most relevant tool for advocating ketamine's efficacy in treating resistant depression and suicidality. Read about Sue's experience at the Umhlanga KetaMIND Clinic below...
"Ketamine saved my life."
"It's like my brain has been rebooted and updated."
Ketamine for crisis management ... Why, whom, and how?
This article summarizes the major clinical studies on ketamine and esketamine efficacy in patients experiencing a crisis (generally, suicidal ideation), and proposes a profile of patients who can benefit most from such drugs, on the basis of neurobiological and clinical observations.
There is currently neither agreement nor guidance (globally) on how to best integrate ketamine and esketamine in the clinical care of patients with MDD, SI, SB, or other psychiatric emergencies.
Official release of SASOP's Care Pathway for MDD (which now includes neuromodulators like ketamine) is eagerly awaited.
This ENPP review summarizes the theoretical and empirical bases for ketamine and esketamine's use and provides best practice suggestions.
The article points to the proven efficacy of KIT as a "one-shot" intervention to tackle suicidal crisis, with lack of evidence for esketamine spray's use for this indication.
Dr Rosanne Symons - passionate about her work...
Rosanne Symons has postgraduate diplomas in anaesthesiology and mental health. She has worked at KetaMIND Umhlanga for two-years and she shares some of her views with us in a quick-fire Q & A...
We asked Rosanne to respond to some quick fire questions...
Click on the link below to learn what she finds most satisfying and challenging about treating patients with ketamine infusions.
Read about a memorable outcome in a patient who had set a date for his suicide, and another whose father was in tears after the turnaround in his son's depression.
"Take heart, hold fast, and keep hoping, " is her advice to patients.
Cocaine Dependency - Can Ketamine Infusion help?
To date, no medications are approved for the treatment of cocaine use disorder.
An RCT (n=55) published in the American Journal of Psychiatry reports the effects of a single ketamine infusion on abstinence, craving and relapse, combined with mindfulness-based behavioural modification.
Compared with the control group (midazolam infusion), the results are significant.
This study, conducted at the New York State Psychiatric Institute, reinforces ketamine's utility in the field of addiction and dependency.
It was found that, compared with the midazolam control group, those receiving a single ketamine infusion were: nearly 5-times more likely to maintain abstinence, 53% less likely to relapse, and craving was reduced by almost 60%.
In a previous newsletter, we report the benefit of single ketamine infusions in heavy drinkers.
Read about a Ritalin addict treated with ketamine at KCSA here.
KetaMIND clinics currently offer outpatient ketamine infusions at the following locations:
BEDFORDVIEW (GP)
CONSTANTIA (WC)
UMHLANGA (KZN)
HILTON (KZN)
In the next newsletter..
Choosing a ketamine provider can be a minefield... There has been an explosion of ketamine providers in the USA over the past few years, and this trend is expected in South Africa, particularly following SASOP's recent, formal recognition of ketamine as acceptable treatment for TRD if administered in accordance with their position statement and Care Pathway. Compliance with guidelines from SASA and SOSPOSA, qualifications and experience of staff, appropriate monitoring, track-record, accreditations and memberships, are some of the topics that will be discussed next month and which can guide safe selection. Beware of 'nurse-run' clinics, solo practitioners, intramuscular ketamine, proprietary 'blends', and unsubstantiated claims... |
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. To read more about Dr Howard and KCSA's flagship clinic in the Natal Midlands in two informative articles published in South African Psychiatry click on the link below. A follow-up article, Ketamine Clinics beyond the Hills can be accessed here. |
