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.