Journal Club #9: Is Ketamine Safe with History of Psychosis?

Journal Club #9:

Is Ketamine Safe with History of Psychosis & Implications for Its Therapeutic Use.

Article: JAMA Network Open. 2020 May; 3(5): e204693.

In this journal club, Dr. Lena Palaniyappan will answer the following seven clinically relevant questions:

  1. Can a single dose of ketamine induce acute psychotic episode when given to those who never had psychosis?
  2. Risk of psychosis in patients with a history of schizophrenia.
  3. Do ketamine affect both positive and negative symptoms of schizophrenia?
  4. Role of bolus before continuous infusion of ketamine in producing psychotic symptoms and do this differ for positive versus negative symptoms?
  5. Do psychosis risk differs between intravenous and non-intravenous mode of ketamine delivery?
  6. Timeline for onset and duration of psychosis after ketamine administration.
  7. Role of observer-rated scales for psychosis (BPRS/PANSS) in schizophrenia versus psychosis induced by hallucinogens/psychotomimetics.

This journal club includes an expert discussion section with Dr. Asim Shah. He will answer the following clinical questions:

  1. Should this risk of psychosis stop us from considering ketamine in our practice?
  2. Who is an ideal patient to go for ketamine/esketamine therapy?
  3. Is there a subgroup of depressed patients that may respond better to ketamine?
  4. What is the balanced course of the length of treatment with ketamine?
  5. Is it possible to predict non-responders early on, so we can avoid long exposure?
  6. Advice for practitioners who are still skeptical about the use of ketamine.

Journal Club #9 is Available for Course Subscriber Only:

Psychiatry Education Forum’s Journal Club is a free feature for Physician’s Guide for Clinical Psychiatry course subscribers.


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of PeerPoint Medical Education Institute, LLC and Psychiatry Education Forum LLC. The PeerPoint Medical Education Institute, LLC is accredited by the ACCME to provide continuing medical education for physicians.

The PeerPoint Medical Education Institute, LLC designates this enduring activity for a maximum of 4.25 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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