Ketamine Use in Conversion Disorder

Introduction to Ketamine Contradictions

The American College of Physicians and other medical societies suggest that ketamine has no established role in the treatment of conversion disorder and should not be used for this indication, as the available evidence is limited to treatment-resistant depression, suicidal ideation, and substance use disorders 1, 2, 3

There is a total lack of evidence for ketamine's use in conversion disorder, with no studies, clinical guidelines, or case reports evaluating its use for conversive symptoms (motor or sensory) 1, 2, 3, 4, 5
The approved and studied indications for ketamine are completely different: treatment-resistant major depression, acute suicidal ideation in major depression, and as an anesthetic 1, 3, 5
Conversion disorder has a fundamentally different pathophysiology that does not involve the NMDA-glutamatergic mechanisms that ketamine modulates 2

Ketamine produces dissociative effects, hypertension, psychotomimetic symptoms, and has potential for abuse 5
Administering ketamine requires intensive monitoring of blood pressure, dissociative effects, and possible respiratory depression 3, 5
There is no long-term safety data, with concerns about urological toxicity, neurocognitive effects, and development of substance use disorder 5