Transdermal administration of therapeutic ketamine has been investigated as a potential alternative to traditional routes of administration, such as intravenous (IV) and oral administration, for treating various mental health conditions and depression. However, research on transdermal ketamine is limited, and more studies are needed to establish its safety and efficacy.
Benefits:
- Non-invasive and convenient: Transdermal administration is non-invasive and allows for continuous drug delivery through the skin, providing a convenient method for patients and potentially improving treatment adherence (Paudel et al., 2010).
- Steady drug release: Transdermal patches can offer sustained drug release over an extended period, providing consistent plasma concentrations and potentially reducing dosing frequency (Paudel et al., 2010).
- Bypassing first-pass metabolism: Transdermal administration avoids first-pass metabolism by the liver, which can result in a higher bioavailability than oral administration (Paudel et al., 2010).
Concerns:
- Low overall bioavailability: The bioavailability of ketamine through transdermal administration is not well-established and could be limited due to the drug’s physicochemical properties and the skin’s barrier function (Finnie et al., 2015).
- Dosing: Optimal dosing for transdermal ketamine has yet to be established. More research is needed to determine the most effective and safe dosing regimens and formulations for various indications.
- Potential for skin irritation: Transdermal patches can cause local skin irritation or allergic reactions, which may limit their use in some patients (Paudel et al., 2010).
- The effectiveness of slow induction of ketamine for mental health conditions is doubtful. Ketamine for pain patients is usually much slower than for mental health patients. For mental health conditions patients seem to do better with a brief more intense dosing protocol.
In summary, transdermal administration of therapeutic ketamine may offer benefits such as non-invasive and convenient drug delivery, steady drug release, and bypassing first-pass metabolism. However, concerns include potentially low bioavailability, the need for further research on optimal dosing, and the potential for skin irritation.
Finnie, P. S., Nanan, K., Kim, E., & Cho, H. J. (2015). Transdermal ketamine as an adjuvant for postoperative analgesia after pediatric tonsillectomy: a double-blinded, randomized, controlled trial. International Journal of Pediatric Otorhinolaryngology, 79(8), 1380-1384.
Paudel, K. S., Milewski, M., Swadley, C. L., Brogden, N. K., Ghosh, P., & Stinchcomb, A. L. (2010). Challenges and opportunities in dermal/transdermal delivery. Therapeutic delivery, 1(1), 109-131.