Session Information
Date: Thursday, June 23, 2016
Session Title: Parkinson's disease: Clinical trials, pharmacology and treatment
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To evaluate possible long-term anti-dyskinetic activity of low-dose sub-anesthetic ketamine infusion from a retrospective chart review.
Background: Repurposing drugs that have already been proven safe in humans has the potential to offer new therapies at a fraction of the time required to develop new drug treatments. Low-dose sub-anesthetic ketamine infusion treatment has led to long-term reduction of chronic pain states, including migraine headaches, and to reduction of treatment-resistant depression and posttraumatic stress disorder (PTSD) symptom severity. Ketamine also is known to change oscillatory electric brain activity. One commonality between migraine headaches, depression, PTSD, Parkinson’s disease (PD) and L-DOPA-induced dyskinesia (LID) is hypersynchrony of electric activity in the brain, including the basal ganglia. An effective treatment of LID to extend the useful lifetime of L-DOPA treatment is a critical unmet need in PD therapy.
Methods: We investigated the use of low-dose ketamine in the treatment of PD and LID from a retrospective chart review. Patients were treated in the intensive care unit using a protocol for treatment of intractable pain that specified titration of ketamine to a target rate of 0.15 – 0.3 mg/kg/hr for 50 – 96 hr periods.
Results: There was a long-term therapeutic effect of sub-anesthetic ketamine infusion from five PD patient case studies identified by a retrospective chart review (reduced dyskinesia, reduced pain, improved on time, and reduced depression). There was no significant sedation in any of the cases. A separate abstract presented at this meeting explores mechanisms involved in a rodent preclinical model (Falk, Bartlett, Ye, Lazarus, Heien, Cowen, Sherman; Preclinical evaluation of sub-anesthetic ketamine infusion to reduce L-DOPA-induced dyskinesias: is it a ‘chemical’ DBS?).
Conclusions: This novel use of low-dose sub-anesthetic ketamine infusion could lead to rapid clinical translation for the treatment of dyskinesia. Since comorbid pain states and depression are critical problems for many Parkinson’s disease patients, ketamine could be developed as a multi-faceted treatment.
American Neurological Association Meeting 2015, Chicago.
To cite this abstract in AMA style:
S.J. Sherman, T. Falk. Patient case reports supporting a long-term effect of sub-anesthetic ketamine infusion in reducing L-DOPA-induced dyskinesias [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/patient-case-reports-supporting-a-long-term-effect-of-sub-anesthetic-ketamine-infusion-in-reducing-l-dopa-induced-dyskinesias/. Accessed September 23, 2023.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/patient-case-reports-supporting-a-long-term-effect-of-sub-anesthetic-ketamine-infusion-in-reducing-l-dopa-induced-dyskinesias/