Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood.
Keming Gao, Buket Koparal, Evrim Bayrak Oruc, Margret A Musso
Psychopharmacology Bulletin April 8, 2025 DOI: 10.2147/ndt.S72026 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A patient with treatment-resistant depression and comorbid generalized anxiety disorder, eating disorder, post-traumatic stress disorder, and borderline personality disorder |
| Interventions | antidepressant monotherapy adjunctive therapy with antipsychotics lithium or lamotrigine electroconvulsive therapy ketamine infusion compounded ketamine intranasal spray intranasal esketamine |
| Duration | 10-year period |
| Topics | Depression Esketamine Ketamine |
| Keywords | Comorbidity Electroconvulsive therapy Remission Response Treatment-refractory depression Ketamine-based therapy Treatment-resistant depression trd Ketamine infusion |
| Citations | 99 |
| Key findings | A patient with treatment-resistant depression and multiple comorbidities had two-year stability with compounded ketamine intranasal spray or esketamine at two different times, and remained stable without hospitalization or suicide attempt for more than two years on esketamine. |
Abstract
In this case report, we present a patient with treatment-resistant depression (TRD) and comorbid generalized anxiety disorder, eating disorder, post-traumatic stress disorder, and borderline personality disorder. Over a 10-year period, our case transitioned from adolescence to adulthood and received antidepressant monotherapy, adjunctive therapy with antipsychotics, lithium, or lamotrigine, several series of electroconvulsive therapy (ECT), ketamine infusion (KET-IFU), compounded ketamine intranasal spray (COM-KET), and intranasal esketamine (ESK). She had seventeen documented hospitalizations, five self-reported hospitalizations, three intensive outpatient program treatments, two partial hospitalization program treatments, and three residential treatments. She attempted suicide seven times. She received five acute ECT series, one series of KET-IFU, one series of acute ESK with weekly ECT, a series of COM-KET treatment for more than two years, and a series of ESK for more than two years. The patient had some short-term benefit from ECT and KET-IFU. However, she had two-years stability with COM-KET or ESK at two different times. She has been relatively stable without hospitalization or suicide attempt with ESK for more than two years, suggesting that patients with TRD with complex representations may benefit from ketamine treatment at different times of life development.
Comparable studies
Other case reports and case series on esketamine for depression, most cited first.
Citations in the library
Cited by 8
- Psychedelics and Other Psychoplastogens for Treating Mental Illness Frontiers in Psychiatry October 4, 2021
- Intranasal esketamine use in bipolar disorder: A case report Mental Health Clinician July 1, 2021
- Mindfulness-based cognitive therapy improves insomnia symptoms in individuals with recurrent depression: secondary analyses from a randomized controlled trial. Frontiers in Psychiatry 2023
- Adjunctive ketamine vs. buprenorphine in co-occurring major depressive disorder and opioid use disorder: a randomized, double-blind clinical trial assessing anxiety symptom severity and craving intensity. Trials April 17, 2025
- The Potential Therapeutic Benefits and Safety of Psychedelics in the Treatment of Mental Health Conditions: A Systematic Review Journal of Sociology, Psychology & Religious Studies November 6, 2023
and 3 more in the library