Introduction
treatment-resistant depression, non-malignant life-limiting, depressive disorder, neurocognitive adverse, MDD
ADVANCED CANCER
Individuals with palliative care needs facing advanced cancer and non-malignant life-limiting illnesses often experience a myriad of stressors that predispose them to the development of major depressive disorder (MDD), affecting 10–20% of this population [Recognising, assessing, and managing MDD can be challenging in the palliative care setting [Ketamine, an N-methyl-D-aspartate (NMDA) antagonist used as a dissociative anaesthetic, has been found to exhibit rapid-onset antidepressant activity in otherwise well people with treatment-resistant depression at sub-anaesthetic doses of 0.5mg/kg given over 40 minutes intravenously or as subcutaneous boluses, and is generally well-tolerated [However, in the literature, there are concerns about ketamine causing neurocognitive adverse effects when used in the palliative care setting, even when given at lower dosages [Prior to conducting a definitive trial to assess ketamine’s effectiveness as an antidepressant compared to standard care, the feasibility of conducting such a study needs to be explored, along with its effects and tolerability in this population [