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Intravenous ketamine therapy in a patient with a treatment-resistant major depression

M Liebrenz, A Borgeat, R Leisinger

Swiss Medical Weekly April 21, 2007 DOI: 10.4414/smw.2007.11852 via OpenAlex

Summary

AI-generated from the abstract

A single intravenous infusion of ketamine (0.5 mg/kg) produced a rapid and substantial improvement in depression symptoms in a 55-year-old man with treatment-resistant major depression and co-occurring alcohol and benzodiazepine dependence. Depression scores dropped by more than half within two days, with the Hamilton Depression Rating scale falling from 36 to 16 and the Beck Depression Inventory from 26 to 9. The patient reported feeling better within 25 minutes of the infusion, and the positive effects lasted for at least seven days. The presence of substance use disorders did not diminish ketamine's antidepressant action.

Study at a glance

Characteristics Open label trial Open-label Peer reviewed
Sample size 1
Population 55-year-old male with treatment-resistant major depression and co-occurring alcohol and benzodiazepine dependence
Intervention Ketamine hydrochloride
Dose 0.5 mg/kg
Duration 50-minute infusion, assessed at 1 hour, 1 day, 2 days, and 7 days post-infusion
Citations 75
Key finding A single intravenous ketamine infusion produced rapid and sustained antidepressant effects in a patient with treatment-resistant depression and co-occurring substance use disorders.

Abstract

BACKGROUND: Recently, reports from North America have indicated that the intravenous infusion of ketamine hydrochloride (an N-methyl-d-aspartate receptor antagonist) results in a sudden and robust improvement of depression symptoms. OBJECTIVE: To corroborate antidepressant effectiveness of IV ketamine in a patient with a co-occurring substance use disorder for the first time in a European clinical setting. DESIGN: Open label trial Methods: A 55-year-old male subject with a treatment-resistant major depression and a co-occurring alcohol and benzodiazepine dependence received an intravenous infusion of 0.5 mg/kg ketamine over a period of 50 minutes. Effects were assessed by means of a clinical interview, the 21-item Hamilton Depression Rating scale (HDRS), and the 21-item Beck Depression Inventory (BDI) at baseline, 1 hour, 1 day, 2 days, and 7 days after intervention. RESULTS: Following the administration of ketamine the subject experienced a significant improvement of his symptoms peaking on the 2nd day post infusion (HDRS from 36 to 16; -56.6%, BDI from 26 to 9; -65.4%). The subject first reported improvements 25 min. into the infusion and continued to describe positive effects throughout the subsequent 7 days. CONCLUSION: Ketamine not only seems to have strong antidepressant effects but also to act very swiftly. These actions were unaffected by an alcohol or benzodiazpine dependence.

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