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 DOI: 10.3390/medicina60060936 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Patient with treatment-resistant bipolar depression |
| Interventions | Electroconvulsive therapy Ketamine infusion Deep repetitive transcranial magnetic stimulation |
| Dose | 0.5-0.75 mg/kg for 40 min |
| Topics | Depression Esketamine Ketamine |
| Keywords | Electroconvulsive therapy Ketamine infusion Remission Response Treatment-resistant bipolar depression Neuromodulation therapy Alternative treatments Psychiatric interventions Mood disorders |
| Citations | 1 |
| Key findings | A patient with treatment-resistant bipolar depression who failed ECT and ketamine infusion responded well to dTMS and maintained stability for over 2 years. |
Abstract
Background and
Objectives: Options for treatment-resistant bipolar depression (TRBPD) are limited. Electroconvulsive therapy (ECT) has shown efficacy in TRBPD. However, the cognitive deficits and memory concerns associated with ECT are problematic for a significant number of patients. It remains unclear what the next step is for patients with TRBPD who fail ECT.
Materials and Methods: In this case report, we present a patient with TRBPD who sequentially received 12 sessions of brief-pulse right unilateral ECT, 22 sessions of ketamine infusion at 0.5-0.75 mg/kg for 40 min, and 39 sessions of deep repetitive transcranial magnetic stimulation (dTMS).
Results: The patient had some benefit from ECT, but declined continuation of ECT due to memory concerns. The patient tolerated ketamine infusion well but had limited benefit. However, the patient responded well to acute treatment with dTMS and maintained relative stability for more than 2 years.
Conclusions: This case suggests that patients with TRBPD who fail ECT and/or ketamine infusion might benefit from dTMS.
Comparable studies
Other case reports and case series on ketamine for depression, most cited first.