Use of repeated intravenous ketamine therapy in treatment-resistant bipolar depression with suicidal behaviour: a case report from Spain.
Álvaro López-díaz, José Luis Fernández-gonzález, José Evaristo Luján-jiménez, Sara Galiano-rus, Luis Gutiérrez-Rojas
Therapeutic advances in psychopharmacology April 1, 2017 Peer reviewed DOI: 10.1177/2045125316675578 via PubMed
Summary
A female patient with treatment-resistant depressive bipolar disorder and chronic suicidal behavior underwent multiple intravenous ketamine infusions, resulting in complete recovery for 4 weeks post-discharge. However, her depressive symptoms recurred in the 5th week, leading to a suicide attempt and subsequent readmission to the hospital. This case highlights the temporary nature of ketamine's effects and the ongoing risks associated with its use.
Study at a glance
| Design | case study |
|---|---|
| Sample size | 1 |
| Population | a female patient with treatment-resistant depressive bipolar episode |
| Key finding | The patient achieved complete clinical recovery after ketamine treatment, but depressive symptoms returned within five weeks, culminating in a suicide attempt. |
Abstract
The rapidly-acting antidepressant properties of ketamine are a trend topic in psychiatry. Despite its robust effects, these are ephemeral and can lead to certain adverse events. For this reason, there is still a general concern around the off-label use of ketamine in clinical practice settings. Nonetheless, for refractory depression, it should be an indication to consider. We report the case of a female patient admitted for several months due to a treatment-resistant depressive bipolar episode with chronic suicidal behaviour. After repeated intravenous ketamine infusions without remarkable side effects, the patient experienced a complete clinical recovery during the 4 weeks following hospital discharge. Unfortunately, depressive symptoms reappeared in the 5th week, and the patient was finally readmitted to hospital as a result of a suicide attempt.