Treatment of compulsive behaviour in eating disorders with intermittent ketamine infusions

I. Mills
1998 QJM: Quarterly journal of medicine  
We have previously shown that eating disorders are of eating disorder, all of whom were chronic and resistant to several other forms of treatment. Nine a compulsive behaviour disease, characterized by frequent recall of anorexic thoughts. Evidence sug-(responders) showed prolonged remission when treated with two to nine ketamine infusions at inter-gests that memory is a neocortical neuronal network, excitation of which involves the hippocampus, vals of 5 days to 3 weeks. Clinical response was
more » ... sociated with a significant decrease in Compulsion with recall occurring by re-excitement of the same specific network. Excitement of the hippocampus by score: before ketamine, mean±SE was 44.0±2.5; after ketamine, 27.0±3.5 (t test, p=0.0016). In six glutamate-NMDA receptors, leading to long-term potentiation (LTP), can be blocked by ketamine. patients (non-responders) the score was: before ketamine, 42.8±3.7; after ketamine, 44.8±3.1. There Continuous block of LTP prevents new memory formation but does not affect previous memories. was no significant response to at least five ketamine treatments, perhaps because the compulsive drive Opioid antagonists prevent loss of consciousness with ketamine but do not prevent the block of LTP. was re-established too soon after the infusion, or because the dose of opioid antagonist, nalmefene, We used infusions of 20 mg per hour ketamine for 10 h with 20 mg twice daily nalmefene as opioid was too low. antagonist to treat 15 patients with a long history
doi:10.1093/qjmed/91.7.493 pmid:9797933 fatcat:2s4egxirjbhvphrbosrcyxwsxy