Attention deficit hyperactivity disorder (ADHD) is characterized by persistent inattention, hyperactivity, and impulsivity [1]. Common symptoms include:
- Difficulty sustaining focus and attention to tasks
- Forgetting instructions, losing items
- Fidgeting, restlessness
- Excessive talking and interrupting
- Problem waiting turns or waiting in line
- Acting without thinking, blurting things out
Symptoms are present in multiple settings and impair functioning. There are three subtypes – predominantly inattentive, hyperactive/impulsive, and combined type [2].
Ketamine has shown potential for temporarily reducing the core symptoms of ADHD by positively modulating glutamate signaling and dopamine release in areas like the prefrontal cortex [3].
Small studies have found a single subanesthetic ketamine infusion can rapidly improve attention, focus and vigilance for 1-2 weeks in adults with ADHD [4]. More extensive controlled trials are still needed.
While ketamine is not a standalone treatment for ADHD, its short-term effects on attention and behavior regulation could provide a window for beginning behavior therapies or skill-building that improve outcomes long-term when combined with standard stimulant medications [5].
References:
[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
[2] CDC. (2022). Learn About Attention-Deficit/Hyperactivity Disorder (ADHD). https://www.cdc.gov/ncbddd/adhd/facts.html
[3] De Berardis D, Fornaro M, Orsolini L, et al. The Role of Glutamatergic Agents in the Treatment of Major Depressive Disorder. CNS Neurol Disord Drug Targets. 2016;15(1):105-115. doi:10.2174/1871527314666151116120011
[4] Feifel D, Malcolm B, Boggie D, Lee K. Low-dose ketamine for adult attention deficit hyperactivity disorder comorbid with treatment-resistant depression: An open-label pilot study. J Affect Disord. 2016;195:116-121. doi:10.1016/j.jad.2016.02.020
[5] Kadamparambathu RA, Williamson DJ, Vahabzadeh A. The Potential Use of Low-Dose Ketamine for Adults With Attention-Deficit/Hyperactivity Disorder. J Clin Psychopharmacol. 2019;39(3):238-242. doi:10.1097/JCP.0000000000001005