Journal Article Annotations
2024, 3rd Quarter
Annotations by Liliya Gershengoren, MD
October, 2024
The finding:
This systematic review looked at whether ketamine could be effective in treating catatonia, a complex and sometimes treatment-resistant condition. Across 20 studies involving 25 patients, most of whom were treated with intravenous ketamine, 80% showed improvement and 44% achieved remission of catatonic symptoms. The review suggests that ketamine, particularly in mood disorder-related catatonia, holds promise as a therapeutic option, with minimal reports of worsening symptoms. Only one patient had to stop due to dissociative effects.
Strengths and weaknesses:
The review shines a light on a novel and potentially game-changing approach to treating catatonia, especially in cases where standard treatments like benzodiazepines or ECT fall short. However, it leans heavily on case reports and lacks controlled trials, which makes it difficult to draw firm conclusions. The small sample size and inconsistent use of standardized tools to measure catatonia severity are also limiting factors.
Relevance:
This study is highly relevant for consultation-liaison psychiatrists, as catatonia is frequently encountered in hospital settings. The potential for ketamine to be used as an alternative or adjunctive treatment in catatonia is an exciting prospect. Additionally, its application in patients with mood disorders may offer a new avenue for treatment in refractory cases, making it a valuable option in CL psychiatry.