Why ketamine

Epilepsy Behav. 2023 Apr:141:109066. doi: 10.1016/j.yebeh.2022.109066. Epub 2023 Jan 4.

Abstract

We present the rationale for testing ketamine as an add-on therapy for treating benzodiazepine refractory (established) status epilepticus. In animal studies, ketamine terminates benzodiazepine refractory status epilepticus by interfering with the pathophysiological mechanisms and is a neuroprotectant. Ketamine does not suppress respiration when used for sedation and anesthesia. A Series of reports suggest that ketamine can help terminate refractory and super refractory status epilepticus. We propose to use 1 or 3 mg/Kg ketamine intravenously based on animal-to-human conversion and pharmacokinetic studies. This paper was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022.

Keywords: Established status epilepticus; NMDA receptor; Neuroprotection; Pharmacokinetics.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anticonvulsants
  • Benzodiazepines / pharmacology
  • Humans
  • Ketamine* / administration & dosage
  • Ketamine* / therapeutic use
  • Neuroprotective Agents* / administration & dosage
  • Neuroprotective Agents* / therapeutic use
  • Seizures / drug therapy
  • Status Epilepticus* / drug therapy

Substances

  • Ketamine
  • Anticonvulsants
  • Benzodiazepines
  • Neuroprotective Agents