Brain Sciences
January 13, 2023
Maria Gałuszko‐węgielnik, Zuzanna Chmielewska, Katarzyna Jakuszkowiak‐wojten et al.
20 citations
Psychotic treatment-resistant depression is a severe form of major depressive disorder involving hallucinations or delusions, often underdiagnosed and undertreated. Ketamine has shown rapid antidepressant effects, and its enantiomer esketamine was approved for treatment-resistant depression in 2019. This report describes four inpatients with treatment-resistant depression and psychotic features, including one in severe suicidal crisis, who received a single 0.5 mg/kg intravenous infusion of ketamine as an add-on to standard care. Monitoring showed no worsening of psychotic symptoms in short or long term, and all patients achieved stable remission with an immediate antisuicidal effect. Ketamine may benefit individuals with this condition.
Adam Włodarczyk, Wiesław J. Cubała, Maria Węgielnik-gałuszko et al.
1 citation
In patients with treatment-resistant depression, intravenous ketamine appears safe regarding dissociative and psychotic symptoms, but those with epilepsy require close monitoring. Among 49 inpatients with major depressive or bipolar disorder and somatic comorbidities, psychotic symptom scores changed significantly over time only in the epilepsy subgroup. For other somatic conditions, no significant psychotic symptom changes occurred regardless of depression diagnosis. The study was small, unblinded, and limited to a single site, so findings are preliminary.
Research Square (Research Square)
Adam Włodarczyk, Wiesław J. Cubała, Maria Węgielnik-gałuszko et al.
In hospitalized patients with treatment-resistant depression (major depressive or bipolar disorder), intravenous ketamine treatment was associated with changes in psychotic symptoms over time among those with epilepsy, but not among those with other somatic conditions. The study, which included 49 participants and was limited by a small, unblinded, single-site design, suggests that careful monitoring for psychotic symptoms is needed when using ketamine in patients with epilepsy, and that somatic comorbidities may influence dissociative side effects.