Ketamine treatment for buprenorphine-precipitated opioid withdrawal: a case report.
Frontiers in psychiatry January 1, 2025 Ezioma Gbujie, Lisa Vercollone, Joji Suzuki 2 citations
A 72-year-old man hospitalized for hematuria developed severe opioid withdrawal when buprenorphine/naloxone was initiated. Two high-dose attempts failed, and standard symptom-relief medications did not help. A single intravenous 27 mg bolus of ketamine briefly improved symptoms but caused emergence delirium, treated with haloperidol. The patient was eventually stabilized on buprenorphine/naloxone 8 mg twice daily. The case suggests ketamine may be an effective adjunct for managing opioid withdrawal, but its use on general medical floors carries risks such as delirium, warranting further safety research.