Antidepressant effect of intranasal ketamine in the palliative care of terminally ill cancer patients

Background: patients with cancer are more likely to have affective disorders. Antidepressant treatments take weeks to work. Evidence suggests that ketamine delivered by any route treats these symptoms, making it a recommendable option for oncologic patients what are they presenting depression, anxiety, and suicidal ideation. Material and methods: a randomized, double-blind, placebo -controlled study was conducted in 142 participants with cancer. Ketamine at 0.5 mg / kg and 1m of placebo at 0.9% were administered intranasally every six hours for 3 days. The criterion used to evaluate efficacy was the total score on the Montgomery-Asberg Depression rating scale. In addition, response time and adverse events to treatment were analyzed. Results: the mean age was 69.11 +/- 9.77 years. The most frequent carcinoma was the pancreatic head tumor (44.37%). Affective disorders improved significantly only in Group A (p <0.001). Group B presented improvements induced by the placebo effect, but no significant differences were found (p = 0.32). The main side effect was nausea in both cases. Conclusions: ketamine administered intranasally is a safe, effective, and rapid therapy to reduce antidepressant effects and improve the quality of life of cancer patients. The response rate is similar to other studies. The adverse effects may limitation for its application.