Monomamine oxidase inhibithors and intravenous ketamine: a safe association?

• Autor(a) principal: Santos, Juliana Machado Leal dos
• Data de Publicação: 2022
• Outros Autores: Couto, Hugo Leonardo de Oliveira, Monteiro, Dennison Carreiro
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Debates em Psiquiatria (Online)
• Texto Completo: https://revistardp.org.br/revista/article/view/219
• topic: segurança; inibidores da monoaminoxidase; cetamina; pressão sanguínea; safety; monoamine oxidase inhibitors; ketamine; blood pressure; seguridad; inhibidores de la monoaminooxidasa; ketamina; presión arterial

Introduction: Ketamine emerges as a quick and effective drug in the treatment of Treatment-Resistant Depression (TRD), and it is the first drug with an action mechanism outside the monoaminergic system approved for this purpose. Patients with TRD use, or will often be prescribed, monoamine oxidase inhibitors (MAOIs). Among other mechanisms, ketamine presents sympathomimetic effects through the inhibition of norepinephrine reuptake. The risks of the concomitant use of MAOIs and some noradrenergic drugs are already established. Thus, the possibility of hypertensive crises resulting from the combination of these drugs requires clinical attention. Objective: The objective of this review was to verify important aspects regarding this combination, which are the occurrence of hypertensive crises and other cardiovascular effects. Method: The study was carried out through Pubmed, Scielo and Lilacs databases, dated from 1990 until March 2021, using the following combination of descriptors: (Monoamine oxidase inhibitor) AND (Ketamine). Result: The results demonstrate the safety and efficacy of the combination, with transient heart rate and blood pressure elevation, which showed no consequences for patients. Conclusion: However, the data were found in reports and case series and in a small retrospective cohort, so it is possible that serious side effects were not detected in such small samples.