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Very Low-Dose Sublingual Ketamine for Borderline Personality Disorder and Treatment-Resistant Depression.

Mitchell B. Liester, Rachel Wilkenson, Barry Patterson, Bertrand Liang

Cureus April 1, 2024 DOI: 10.7759/cureus.57654 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population Woman with borderline personality disorder and treatment-resistant depression
Intervention sublingual ketamine
Dose very low-dose
Topics Depression Esketamine Ketamine
Keywords Ampa receptor Brain-derived neurotrophic factor Glutamate dysregulation Low dose ketamine Neuroplasticity enhancement Ketamine therapy Treatment-resistant mental health Neuroscience research Psychiatric medicine Personality disorders
Citations 3
Key findings Very low-dose sublingual ketamine may be effective for treating borderline personality disorder and/or comorbid treatment-resistant depression.

Abstract

Borderline personality disorder (BPD) and treatment-resistant depression (TRD) are common mental disorders that are challenging to treat. Ketamine is an N-methyl-D-aspartate receptor antagonist that has shown promise as a rapid-acting antidepressant when administered intravenously. BPD symptoms have also been demonstrated to improve with repeated intravenous administration of ketamine, and a single case report described improvement in BPD following the intranasal administration of esketamine. We present a case report of a woman with BPD and TRD who responded to treatment with very low-dose sublingual ketamine. Very low-dose sublingual ketamine may be effective for the treatment of psychiatric disorders such as BPD and/or comorbid TRD.

Comparable studies

Other case reports and case series on ketamine for depression, most cited first.

Study Year Design Participants
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. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
A longitudinal case series of IM ketamine for patients with severe and enduring eating disorders and comorbid treatment‐resistant depression Patients with enduring eating disorders and treatment-resistant depression 2021 Case series n = 4
Effects of intranasal (S)-ketamine on Veterans with co-morbid treatment-resistant depression and PTSD: A retrospective case series Veterans with co-morbid depression and PTSD 2022 Retrospective case series n = 35
Case report: Intramuscular ketamine or intranasal esketamine as a treatment in four patients with major depressive disorder and comorbid anorexia nervosa Patients with anorexia nervosa and a comorbid depressive disorder treated at a private... 2023 Case report n = 4
Repeated oral esketamine in patients with treatment resistant depression and comorbid posttraumatic stress disorder Patients with treatment-resistant depression and comorbid PTSD 2023 Case series n = 5

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