Wednesday, August 12, 2015

Ketamine May Reduce Behavioral Dysregulation in Children, Case Study Suggests

Chance observations of the effects of medications prescribed for other purposes have often led to the discovery of their psychiatric applications. The use of stimulants for attention-deficit/hyperactivity disorder or the adaptation of an antihistamine into chlorpromazine are just two examples.

Now researchers from the University of Minnesota have presented a hypothesis-generating case report describing how ketamine, an anesthetic now being studied for its antidepressant effects, was associated with symptomatic improvement in a 7-year-old boy with extreme behavioral dysregulation.

The boy exhibited such severe outbursts that he was placed in a long-term residential facility and often required physical restraints, reported Anna Donoghue, M.D., a PGY-1 resident in psychiatry at the University of Minnesota, and colleagues, online August 10 in the journal Pediatrics. However, after receiving ketamine twice (once for a tonsillectomy and later for magnetic resonance imaging), caregivers noted that the boy’s symptoms remitted (for 13 days after the first occasion and for 8 days after the second). During these periods of remission, he also proved more responsive to psychotherapy.

Just how ketamine might have induced such improvement was not clear to the authors. The drug might increase neuroplasticity, “opening the door for the possibility of recovery through engagement in therapy,” they suggested.

“This case report suggests the need for future study using ketamine as a treatment option for children with a history of trauma and severe behavioral dysregulation who have not responded to first-line medication and behavioral therapy approaches.”

For related information, see the Psychiatric News article “The Ketamine Challenge: When Practice Leaps Ahead of Science.”

(Image: Iordani/


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