Intravenous ketamine infusions in patients with depression and Epilepsy: Case series.
Mariusz Stanisław Wiglusz, Zuzanna Chmielewska, Wiesław Jerzy Cubała
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia December 1, 2024 DOI: 10.1016/j.jocn.2024.110908 via PubMed
Summary
AI-generated from the abstractLow-dose intravenous ketamine was safe and well tolerated in six patients with both depression and epilepsy. Side effects were mild and temporary, and no worsening of seizures occurred. Four of the six patients showed a significant reduction in depression scores on the Montgomery-Åsberg Depression Rating Scale, with two achieving full remission. Three patients reported a subjective decrease in seizure activity over twelve months. No serious adverse events happened. The authors caution that this is a small, post-hoc observation and that larger prospective studies are needed to confirm effects on seizures, depression, and side effects.
Study at a glance
| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 6 |
| Population | Patients diagnosed with major depressive disorder or bipolar disorder I and concurrent epilepsy |
| Intervention | Intravenous ketamine |
| Dose | low-dose |
| Duration | Eight intravenous infusions, twelve-month follow-up |
| Topics | Depression Ketamine |
| Keywords | Case report Intravenous #depression-treatment depression therapy Mood disorder treatment #epilepsy-management seizure control |
| Citations | 1 |
| Key finding | Short-term intravenous ketamine showed a favorable safety and tolerability profile with clinical efficacy in six patients with depression and epilepsy. |
Abstract
Mood disorders affect approximately one-third of individuals with epilepsy, posing an increased risk of suicide. There is an unquestionable need for more effective antidepressant treatment in this group of patients. This study explores the safety and tolerability of low-dose intravenous ketamine in six patients with comorbid depression and epilepsy. This report is limited to the post-hoc observation of six patients only. Thus, no causative conclusions are warranted, and prospective, large sample studies are needed to demonstrate the effect of ketamine on seizures, depression, and side effect profile along with the systematic outcome measures assessment. Six patients diagnosed with major depressive disorder (MDD) or bipolar disorder I (BP-I) and concurrent epilepsy received a series of eight intravenous ketamine infusions alongside their standard antidepressant, mood stabilizer, and antiseizure medications. The observed side effects were mild and transient, with no exacerbation of epilepsy noted. No serious adverse events occurred. Four patients experienced a significant reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) scores, two achieving full remission. Three patients reported a subjective decrease in seizure activity during the twelve-month follow-up. Short-term intravenous ketamine treatment demonstrated favorable safety and tolerability profile with clinical efficacy in six patients with depression and epilepsy.