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conferenceseries LLC Ltd
6th World Congress on
Mental Health, Psychiatry and Wellbeing
March 20-21, 2019 | New York, USA
INTERNATIONAL JOURNAL OF EMERGENCYMENTAL HEALTH AND HUMAN RESILIENCE 2019, VOLUME 21
DOI: 10.4172/1522-4821-C2-029
Using IV ketamine in a
real-world psychiatry
practice to stop suicidal
ideation and avoid
hospitalization
Lori Calabrese
Innovative Psychiatry, USA
Recent inpatient studies
examining the effect of single
ketamine infusions in treatment-
resistant depression (TRD)
have shown promising results
in diminishing suicidal ideation
(SI). We describe the efficacy of
serial titrated ketamine infusions
in stopping suicidal ideation and
averting hospitalization in a large,
naturalistic sample of outpatients
with TRD and complex psychiatric
comorbidity in a real-world
psychiatry practice. Retrospective
chart review of 235 adults and
adolescents presenting with
TRD and complex psychiatric
comorbidity in a large real-
world psychiatry office practice
seeing >5400 visits/year. Each
patient underwent a 60-90min
comprehensive diagnostic
consultation by the single
treating psychiatrist. Appropriate
patients were treated with 6
sub-anesthetic escalating dose
ketamine infusions (0.5-1.2mg/
kg over 40-50min) over 2-3weeks.
PHQ-9 was obtained at baseline
and before each infusion. The
presence, frequency, and intensity
of PHQ-9 item 9 was analyzed
over the course of treatment and
correlated to an overall decrease
in PHQ-9. Suicides, attempts, ER
visits, and hospitalizations were
analyzed over the treatment
course and the following 4 weeks.
64% of the patients presented
with SI. No suicides, attempts, ER
visits or hospitalizations occurred.
SI ceased in 68.4% and markedly
diminished in 81.8%. Remission
of SI was bimodal, occurring
after 1 infusion in 30.6%; the
remainder required 3.3 infusions
and an average dose of 0.75mg/
kg for the remission of SI. Suicidal
patients experienced greater
response and remission of TRD
than non-suicidal patients. This
is the first report of using serial
ketamine infusions in a real-world
psychiatry practice for adults
and adolescents with TRD and
complex psychiatric comorbidity
to safely and rapidly treat severe
suicidal ideation and avert
hospitalization. It represents the
largest number of patients to
date reported from a single site in
studies of IV ketamine infusions
for TRD and suicidality, and a
potential breakthrough treatment
option for psychiatrists to provide
in their offices.
Biography
Lori Calabrese, MD specializes in the
comprehensive and state-of-the-art psychiatric
evaluation and innovative psychiatric
treatment of adults and adolescents at
Innovative Psychiatry in Connecticut. She was
educated at The Johns Hopkins University
School of Medicine, completed her residency
at Massachusetts General Hospital/Harvard
Medical School, and has served as clinical
faculty at Harvard and Yale. She is often
thought of like a doctor’s doctor and a leader
among her peers. She is the first psychiatrist
in CT to offer a full array of treatment
options with IV ketamine infusions within the
context of a comprehensive outpatient office
practice, with TMS, psychopharmacology, and
psychotherapy. In 2018, she presented her
work with IV ketamine internationally at the
First International Conference for Ketamine
and Related Compounds for Psychiatric
Disorders in Oxford, England and at KRIYA
Conference 2018 in San Francisco, California.
She is a member of the American Society of
Ketamine Physicians.
SCIENTIFIC TRACKS| DAY 1