Ketamine is an effective treatment for status epilepticus that does not respond to normal treatments, according to a new study from Spain.
The researchers concluded it was “an effective drug with a good response rate” and few major side effects. They also found that patients who were successfully treated had a shorter average hospital stay.
They said a “good response” was observed in 57% of patients.
Status epilepticus (SE) is when a seizure lasts a long time or when a person has one seizure after another without recovering in between.
In the UK, ketamine is sometimes used to treat SE. It is also used as an anaesthetic. Some studies have suggested it could be used to treat anxiety and depression. However, it has many side effects – especially when taken in large doses.
It is currently also used to treat eclampsia, pre-eclampsia, head trauma, high blood pressure, brain injuries, heart attacks and strokes.
The Spanish researchers were based in Madrid hospitals: Hospital Universitario de Fuenlabrada, Hospital Universitario Clínico San Carlos, Hospital Universitario Quirónsalud and Barcelona’s Hospital Universitari Vall d’Hebron.
The team studied adult patients who received ketamine for the treatment of refractory status epilepticus and super-refractory status epilepticus.
Refractory SE is when first and second treatments fail. Super-refractory is when seizures persist or recur after treatment for more than 24 hours.
Ketamine was used as an anaesthetic after an average of 37 hours of status epilepticus. Some patients were also treated with midazolam. 58 patients took part with an average age of 60. 31 patients died during hospitalisation.
Previous studies have also considered ketamine as a treatment for SE. A 2023 study in the US found that ketamine was increasingly being used to treat refractory SE. In a similar study from August 2022, ketamine had a 60% success rate. This study used data collected over 10 years from 879 patients.
Despite recommending the drug, the researchers added that “clinicians should continue to be cautious when using ketamine, as it is a potent drug with numerous reported adverse effects”.