Very Low-Dose Sublingual Ketamine for Borderline Personality Disorder and Treatment-Resistant Depression.

A woman with borderline personality disorder and treatment-resistant depression improved after taking very low doses of ketamine under the tongue. Ketamine, typically given intravenously, has shown rapid antidepressant effects and can also reduce borderline personality disorder symptoms when given repeatedly through a vein. A single previous case reported improvement with intranasal esketamine. This case suggests that very low-dose sublingual ketamine may be an effective treatment for psychiatric conditions like borderline personality disorder and co-occurring treatment-resistant depression.

Study at a glance

Abstract

Borderline personality disorder (BPD) and treatment-resistant depression (TRD) are common mental disorders that are challenging to treat. Ketamine is an N-methyl-D-aspartate receptor antagonist that has shown promise as a rapid-acting antidepressant when administered intravenously. BPD symptoms have also been demonstrated to improve with repeated intravenous administration of ketamine, and a single case report described improvement in BPD following the intranasal administration of esketamine. We present a case report of a woman with BPD and TRD who responded to treatment with very low-dose sublingual ketamine. Very low-dose sublingual ketamine may be effective for the treatment of psychiatric disorders such as BPD and/or comorbid TRD.