Ketamine Works for Refractory Status Epilepticus

Ketamine, an anesthetic drug that is also being used for patients with treatment-resistant depression, may hold promise for refractory status epilepticus (RSE), Detroit, MI researchers report.

In an abstract presented at the American Epilepsy Society 69th Annual Meeting in Philadelphia, PA, Catalina Maideniuc, MD, and colleagues reported on their experience in using the drug at their center over seven years through 2013.

The patients studied were treated in a single neurocritical care unit. The study covered a total of 63 episodes of RSE, nearly half of which were in women with a mean age of 57 years.

Two thirds of these patients had no prior history of epilepsy. Patients had already been given two anti-epileptic drugs but their seizures returned. They were then given intravenous ketamine an infusion rate of 1mg/kg/hour after a loading dose.

On average, their RSE duration was 3.01 days. Patients were maintained of ketamine from one day to 54 days with the median time 4 days and the average time 6.8 days. Adverse events were related to prolonged sedation and intubation but none were specific to ketamine.

They concluded that when ketamine was administered within 48 hours of status epilepticus, it was effective in 82.53% of patients. In those patients seizures did not recur when the ketamine treatment ended.

The drug appeared safe without any specific complication attributed to it, the authors noted.