Ketamine for depression: a potential role in requests for Medical Aid in Dying?
Nicolas Garel, Michka Nazon, Kamran Naghi, Elena Willis, Karl Looper, Soham Rej, Kyle T. Greenway
International Clinical Psychopharmacology September 1, 2023 DOI: 10.1097/YIC.0000000000000462 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A Canadian patient with severe treatment-resistant depression |
| Intervention | Intravenous ketamine infusions |
| Topics | Depression Esketamine Ketamine |
| Citations | 7 |
| Key findings | A patient with treatment-resistant depression who was requesting MAiD achieved remission after intravenous ketamine infusions, the first reported case of an intervention reversing eligibility for MAiD in depression. |
Abstract
Medical Aid in Dying (MAiD) is the act of a healthcare provider ending a patient's life, at their request, due to unbearable suffering from a grievous and incurable disease. Access to MAiD has expanded in the last decade and, more recently, it has been made available for psychiatric illnesses in a few countries. Recent studies have found that such psychiatric requests are rapidly increasing and primarily involve mood disorders as the primary condition. Nevertheless, MAiD for psychiatric disorders is associated with significant controversy and debate, especially regarding the definition and determination of irremediability - that a given patient lacks any reasonable prospect for recovery. In this article, we report the case of a Canadian patient who was actively requesting Medical Assistance in Dying for severe and prolonged treatment-resistant depression until she experienced remarkable benefits from a course of intravenous ketamine infusions. To our knowledge, this is the first report of ketamine or any other intervention yielding remission in a patient who would have otherwise likely been eligible for MAiD for depression. We discuss implications for the evaluation of similar requests and, more specifically, why a trial of ketamine warrants consideration.
Comparable studies
Other case reports and case series on ketamine for depression, most cited first.