Affective Switch Associated With Oral, Low Dose Ketamine Treatment in a Patient With Treatment Resistant Bipolar I Depression. Case Report and Literature Review
Alina Wilkowska, Łukasz P. Szałach, Jakub Słupski, Aleksandra Wielewicka, Małgorzata Czarnota, Maria Gałuszko‐węgielnik, Mariusz S. Wiglusz, Wiesław Jerzy Cubała
Frontiers in Psychiatry June 3, 2020 DOI: 10.3389/fpsyt.2020.00516 via OpenAlex
Summary
Ketamine can rapidly reduce depression in people with treatment-resistant bipolar disorder, but it also carries a risk of triggering mania. This case describes a patient with bipolar I disorder who, after eight low doses of oral ketamine added to their usual treatment, switched from a depressive episode to a manic episode with mixed features. The manic symptoms began two days before the switch became full-blown. The finding highlights the need for careful monitoring of mood changes when using ketamine in bipolar depression.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Bipolar I disorder patient with treatment-resistant depressive episode |
| Intervention | oral ketamine |
| Dose | subanaesthetic doses |
| Topics | Depression Ketamine |
| Keywords | Bipolar disorder Depression economics Depressive symptoms |
| Citations | 9 |
| Key finding | A patient with bipolar I disorder experienced a switch to a manic episode with mixed features after receiving eight subanaesthetic doses of oral ketamine as an add-on treatment. |
Abstract
There is a growing evidence for the rapid and robust antidepressive effect of ketamine in unipolar and bipolar treatment resistant depression although evidence for the risk of affective switch is still limited. This case presents bipolar I disorder patient with treatment resistant depressive episode experiencing a switch to manic episode with mixed features shortly after receiving eight subanaesthetic doses of oral ketamine as an add-on treatment preceded by 2-day period of manic symptoms.