Ketamine subcutaneous continuous infusion for depressive symptoms at home: A case report beyond pain use.
Carolina Simões, Miguel Julião, Patrícia Calaveiras, Paula Câmara, Teresa Santos
Palliative & Supportive Care October 1, 2024 DOI: 10.1017/S1478951524000798 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 70-year-old man with stage IV renal carcinoma and bone metastasis |
| Interventions | Morphine Ketamine Midazolam |
| Dose | 100 mg/day, increased to 250 mg/day |
| Duration | 28-day treatment |
| Topics | Ketamine Esketamine |
| Keywords | Depressive symptoms Home-based palliative care Subcutaneous continuous infusion Ketamine therapy Chronic pain management Depression treatment Home healthcare |
| Citations | 1 |
| Key findings | Continuous subcutaneous infusion of ketamine with morphine improved neuropathic pain, depressive symptoms, and end-of-life distress in a home-based palliative care patient. |
Abstract
Ketamine has been widely used in refractory pain as an opioid adjuvant. Evidence suggests that ketamine can also have an essential role in easing depressive symptoms. Its rapid onset of action makes it a valuable choice in palliative care. We present a case of a 70-year-old man with stage IV renal carcinoma and bone metastasis. The main symptoms included neuropathic pain, depression, and a persistent and severe desire for death. We started continuous subcutaneous infusion with morphine 30 mg and ketamine 100 mg/day. The dose of ketamine was incremented to the maximum of 250 mg/day. During the 28-day treatment, we observed an overall improvement in neuropathic pain, depressive symptoms, and other end-of-life psychological aspects of distress. Only minor psychological side effects were identified, which were controlled by using midazolam in the continuous subcutaneous infusion. Some studies have already demonstrated the benefits of ketamine use in alleviating depression, using parental infusion or oral formulas, which are administered in hospice care. Our report enhances the benefit of the subcutaneous route for palliative patients cared for at home.
Comparable studies
Other case reports and case series on ketamine, most cited first.