Ketamine Alleviates Fear,Depression,and Suicidal Ideation in Terminally Ill Patients

Dear Editor:

There are many terminally ill patients who suffer from anxiety, fear of death, severe depression, and often suicidal ideation. In the last 20 years, in the intensive care unit (ICU) at Kenneth Norris Cancer Hospital we have used ketamine and narcotic combinations successfully. We have observed that terminally ill patients who received ketamine did not suffer of the above symptoms in comparison to those who were treated conventionally with opiates and benzodiazepines.

Ketamine, a phencyclidine derivative, has analgesic, amnesic and anesthetic effects. Its mechanism of action is predominantly mediated by N-methyl-d-aspartic acid (NMDA) receptors as noncompetitive antagonist for glutamate.^1,2 Recent clinical studies suggest that ketamine rapidly relives symptoms of major depressive illness. ³

Based on our experience we recommend that patients with severe anxiety, depression, and suicidal ideation receive ketamine as part of their treatment.