Ketamine troche

[xavier2000]

Been seeing ketamine troches pop up more and more from patients coming through the hospital.

Is it me or is this a little scary to flying around out there. Last patient tried to tell me they take 100 mg daily. Is this helpful or the next in a line of cash money grabs?

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[NickNaylor]

I've also seen this pop up seemingly out of the blue over the last several months. Went from seeing this never to now having come across multiple patients receiving troches. There's some evidence to support its use, but the evidence is pretty limited and it doesn't seem like there's an agreed upon protocol for its use. I imagine some enterprising folks are trying to strike out and jump on the hype of esketamine and going off the beaten path.

 

[michiganpsych08]

I just had a patient tell me about this. It's definitely coming up more.

 

[xavier2000]

I don't know what was more scary - that or her Effexor IR 100 tid, Cymbalta 30 bid, Geodon 40 am, Klonopin 1 tid, Belsomra 20 hs, Wellbutrin SR 200 bid, trazodone 200 hs or.....wait for it......gabapentin 100 mg am. And it wasn't even rx from an NP.

 

[calvnandhobbs68]

I don't know what was more scary - that or her Effexor IR 100 tid, Cymbalta 30 bid, Geodon 40 am, Klonopin 1 tid, Belsomra 20 hs, Wellbutrin SR 200 bid, trazodone 200 hs or.....wait for it......gabapentin 100 mg am. And it wasn't even rx from an NP.

When I wonder sometimes if I’m giving good patient care…I pull up a great med regimen like this to reassure myself.

Yo but where the stimulant tho

 

[clausewitz2]

When I wonder sometimes if I’m giving good patient care…I pull up a great med regimen like this to reassure myself.

Yo but where the stimulant tho

Written one assumes by Dr. Placebo, who completed an unaccredited fellowship in Non-Specific Effects Psychiatry at Hollywood Upstairs Medical College.

 

[FlowRate]

For anyone who didn't want to google it, troche is a fancy word for "medicated lozenge." TIL.

 

[SourceOfDenial]

Been seeing ketamine troches pop up more and more from patients coming through the hospital.

Is it me or is this a little scary to flying around out there. Last patient tried to tell me they take 100 mg daily. Is this helpful or the next in a line of cash money grabs?

Know a number of patients who benefit from oral dissolving ketamine troches—but they use them in the context of psychotherapy, and it’s definitely not daily.

Definitely not crazy about it with the above medication clusterF.

 

[SpinDktr]

Interesting, there was also a case study/article in AJP this most recent month about a patient who was on oral ketamine (think it was 100 mg qid?) who was hospitalized and went into ketamine withdrawal on an inpatient VA psych unit. I'll see if I can post a link.
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