Case Reports Showing a Long-Term Effect of Subanesthetic Ketamine Infusion in Reducing l-DOPA-Induced Dyskinesias.
Ketamine is an FDA-approved drug with a known safety profile. Low-dose subanesthetic intravenous ketamine infusion treatment has led to long-term reduction of treatment-resistant depression and of chronic pain states. We report on low-dose subanesthetic intravenous ketamine infusion treatment in Parkinson's disease (PD) patients by 5 case studies and show a long-lasting therapeutic benefit to reduce l-DOPA-induced dyskinesia (LID), improve on time, and reduce depression. Based on the literature we hypothesize that low-dose ketamine may act as a 'chemical deep brain stimulation', by desynchronizing hypersynchronous oscillatory brain activity, including in the basal ganglia and the motor cortex. The presented PD case reports indicate tolerability, safety and long-term beneficial effects of low-dose ketamine infusion that should be further investigated in a properly controlled prospective clinical trial for treatment of LID, as well as the prevalent nonmotor features pain and depression in PD patients.
Department of Neurology, University of Arizona, Tucson, Ariz., USA.
Scott J
SJ
Sherman
Neurometrica, LLC, Eugene, Oreg., USA.
Miguel
M
Estevez
Department of Neurology, University of Arizona, Tucson, Ariz., USA.
Ari B
AB
Magill
Department of Neurology, University of Arizona, Tucson, Ariz., USA.
Torsten
T
Falk
Depression; Hypersynchrony; Levodopa; NMDA receptors; Pain; Parkinson's disease