Short term ketamine treatment in patient with bipolar disorder with comorbidity with borderline personality disorder: Focus on impulsivity
Maria Gałuszko‐węgielnik, Katarzyna Jakuszkowiak‐wojten, Alina Wilkowska, Wiesław Jerzy Cubała
The World Journal of Biological Psychiatry June 20, 2023 DOI: 10.1080/15622975.2023.2227901 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Female patient diagnosed with both bipolar disorder and borderline personality disorder |
| Intervention | Intravenous ketamine |
| Topics | Anxiety Depression Ketamine Esketamine |
| Keywords | Borderline personality disorder Impulsivity Bipolar disorder Antidepressant Dissociative Bipolar ii disorder Comorbidity Clinical psychology Population Mood |
| Citations | 9 |
| Key findings | Ketamine initially improved depressive symptoms but later led to increased nonsuicidal self-injury, impulsive behavior, and worsening dissociative symptoms in a patient with comorbid bipolar disorder and borderline personality disorder. |
Abstract
Objectives: Borderline personality disorder (BPD) and bipolar disorder (BD) often co-occur and frequently do not respond adequately to traditional antidepressant treatments. Ketamine has shown rapid antidepressant and anti-suicidal effects. However, there is limited literature on the safety and tolerance of using ketamine to treat patients with comorbid BD and BPD.
Methods: This case presents a female patient diagnosed with both Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) who received intravenous ketamine treatment to alleviate acute depressive symptoms.
Results: Initially, ketamine ameliorated depressed symptoms. However, as the ketamine treatment continued, the patient showed an increase in nonsuicidal self-injury (NSSIs) and impulsive conduct with a aggravation of dissociative symptoms. As a result, intravenous ketamine was discontinued, and the patient received the medication, which proved helpful.
Conclusions: Although ketamine presents antidepressant properties, reports on its impact on emotional dysregulation and impulsive conduct are unclear and not alike to its antidepressant effect. Therefore, there is a need for more studies investigating the effectiveness and safety of this rapid-acting medicine in this patient population.
Comparable studies
Other case reports and case series on ketamine for anxiety, most cited first.