Clinical Scorecard: Esketamine's Role in Treating Functional Neurological Disorder: A Comprehensive Review

At a Glance

Key Highlights

• FND is characterized by motor, sensory, cognitive, and seizure symptoms without structural neurological disease.
• Current treatment approaches emphasize multidisciplinary care but outcomes remain variable.
• Some patients reported improvement in functional symptoms following (Es)ketamine administration.
• Evidence base is limited to uncontrolled studies with substantial heterogeneity.
• Adverse effects of (Es)ketamine are generally transient in supervised clinical settings.

Guideline-Based Recommendations

Diagnosis

• FND should be diagnosed based on clearly described functional neurological symptoms.

Management

• Current management includes multidisciplinary care with psychological interventions.

Monitoring & Follow-up

• Monitor for transient adverse effects during (Es)ketamine administration.

Risks

• Potential for publication and expectancy bias in reported outcomes.

Patient & Prescribing Data

Individuals with FND or comorbid psychiatric conditions.

Improvements in symptoms may arise from direct effects, indirect psychiatric benefits, or non-specific therapeutic factors.

Clinical Best Practices

• Utilize a multidisciplinary approach in managing FND.
• Consider the heterogeneity of FND when interpreting treatment outcomes.
• Further investigation and prospective controlled trials are needed to clarify the role of (Es)ketamine.

Related Resources & Content

• Functional Neurological Disorder Overview
• Ketamine in Neuropsychiatric Practice