Successful treatment for serious depression with suicidal risk in a heart transplant patient.
María Del Mar Arango-Posada, Ana Isabel Prada-Escobar, Carolina Marín-Hernández, Veronica Monsalve-Franco, Diana Restrepo-Bernal
Revista Colombiana de psiquiatria January 1, 2024 DOI: 10.1016/j.rcpeng.2022.03.001 via PubMed
Summary
AI-generated from the abstractA 55-year-old man who had received a heart transplant for heart failure of ischemic origin developed depressed mood, anhedonia, and suicidal ideation six months after the transplant, scoring 20/27 on the PHQ-9 depression screening scale. After a week of mirtazapine 30 mg/night left him at high suicide risk, a 24-hour ketamine infusion produced significant mood improvement and disappearance of suicidal ideation within 24 hours. Depression in transplant patients is associated with graft loss, post-transplant mortality, and other negative outcomes such as deep vein thrombosis. Ketamine infusion was an effective and safe option for treating major depression with suicidal risk in this heart transplant patient.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 55-year-old man with a heart transplant |
| Interventions | Mirtazapine Ketamine infusion |
| Dose | 30 mg/night mirtazapine, 24 h ketamine infusion |
| Duration | One week of mirtazapine, 24-hour ketamine infusion with 24-hour follow-up |
| Topics | Depression Ketamine |
| Keywords | Heart transplantation Ketamina Riesgo suicida Suicide risk |
| Key finding | Ketamine infusion rapidly resolved suicidal ideation and improved mood in a heart transplant patient with major depression. |
Abstract
Major depressive disorder is related to unfavourable outcomes in patients with severe comorbidities. In transplant patients, major depression is associated with worse clinical outcomes. We present the case of a 55-year-old man with a heart transplant due to heart failure of ischaemic origin. Six months after the transplant he developed depressed mood, anhedonia and suicidal ideation with a score of 20/27 on the PHQ-9 depression screening scale. After receiving mirtazapine 30 mg/night for a week and persisting with a high suicide risk, it was decided to administer ketamine infusion for 24 h, with which a significant improvement in mood was observed, and the disappearance of suicidal ideation 24 h after the infusion. Depression in transplant patients is a factor associated with graft loss and post-transplant mortality, in addition to favouring other negative outcomes such as deep vein thrombosis. Ketamine infusion was shown to be an effective and safe option to treat major depression with suicidal risk in a heart transplant patient.