Ketamine infusion combined with accelerated sequential theta burst stimulation in multi-therapy-resistant bipolar depression: A case report.
Asian journal of psychiatry June 1, 2026 Hariprasad Ganapathy Vijayakumar, Varsha Shamanna, Harsh Pathak et al. 1 citation
In a 69-year-old man with chronic multi-therapy resistant bipolar depression, combining intravenous ketamine three times per week with sequential theta burst stimulation led to complete remission that persisted at a two-year follow-up. The patient had previously failed numerous antidepressants, mood stabilizers, electroconvulsive therapy, and standalone brain stimulation. Clinical improvement was measured by a drop in the Hamilton Depression Rating Scale from 15 to 8 and eventually to remission. Electroencephalography showed corrected dysregulated brain activity patterns, suggesting changes in short-term adaptive plasticity. This combination may offer a treatment path for patients who do not respond to standard therapies.