Transcranial magnetic stimulation and intravenous ketamine combination therapy for treatment-resistant bipolar depression: A case report
Laurent Elkrief, Olivier Payette, Jean-Nicolas Foucault, Christophe Longpré-poirier, Maxime Richard, Véronique Desbeaumes Jodoin, Paul Lespérance, Jean-Philippe Miron
Frontiers in Psychiatry September 21, 2022 DOI: 10.3389/fpsyt.2022.986378 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Patient with bipolar treatment-resistant depression |
| Interventions | repetitive transcranial magnetic stimulation intravenous ketamine |
| Topics | Depression Esketamine Ketamine |
| Citations | 15 |
| Key findings | Combination rTMS and ketamine led to complete and sustained remission in a patient with bipolar treatment-resistant depression who had not responded to either treatment alone. |
Abstract
About a third of patients suffering from major depression develop treatment-resistant depression (TRD). Although repetitive transcranial magnetic stimulation (rTMS) and intravenous ketamine have proven effective for the management of TRD, many patients remain refractory to treatment. We present the case of a patient suffering from bipolar TRD. The patient was referred to us after failure to respond to first-and second-line pharmacotherapy and psychotherapy. After minimal response to both rTMS and ketamine alone, we attempted a combination rTMS and ketamine protocol, which led to complete and sustained remission. Various comparable and complimentary mechanisms of antidepressant action of ketamine and rTMS are discussed, which support further study of this combination therapy. Future research should focus on the feasibility, tolerability, and efficacy of this novel approach.
Comparable studies
Other case reports and case series on ketamine for depression, most cited first.
Citations in the library
Cited by 6
- Intravenous ketamine for treatment-resistant depression patients who have failed to respond to transcranial magnetic stimulation: A case series. Journal of Affective Disorders April 1, 2023
- Combination of Transcranial Magnetic Stimulation and Ketamine in Treatment-Resistant Depression: A Systematic Review. Cureus July 1, 2024
- Ketamine infusion combined with accelerated sequential theta burst stimulation in multi-therapy-resistant bipolar depression: A case report. Asian Journal of Psychiatry June 1, 2026
- Role of Electroconvulsive Therapy, Ketamine Infusion, and Deep Repetitive Transcranial Magnetic Stimulation in Treatment-Resistant Bipolar Depression: A Case Report. Medicina (Kaunas, Lithuania) June 3, 2024
- Combining TMS and Ketamine for Treatment-Resistant Depression: Clinical Rationale, Current Evidence, and Practical Guidance. FOCUS: The Journal of Lifelong Learning in Psychiatry July 8, 2026
and 1 more in the library
Cites 9
- Mechanisms of Ketamine Action as an Antidepressant Molecular Psychiatry March 13, 2018
- Neuroplasticity as a convergent mechanism of ketamine and classical psychedelics TIPS - Trends in Pharmacological Sciences September 24, 2021
- Ketamine and other N-methyl-D-aspartate receptor antagonists in the treatment of depression: a perspective review Therapeutic Advances in Chronic Disease April 13, 2015
- The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Recommendations for the Use of Racemic Ketamine in Adults with Major Depressive Disorder: Recommandations Du Groupe De Travail Du Réseau Canadien Pour Les Traitements De L’humeur Et De L’anxiété (Canmat) Concernant L’utilisation De La Kétamine Racémique Chez Les Adultes Souffrant De Trouble Dépressif Majeur The Canadian Journal of Psychiatry November 11, 2020
- The Antidepressant Effect of Ketamine Is Dampened by Concomitant Benzodiazepine Medication Frontiers in Psychiatry August 28, 2020
and 4 more in the library