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Ketamine Self-Medication in a Patient with Autism Spectrum Disorder and Comorbid Therapy-Resistant Depression

Mihriban Heval Özgen, W. van den Brink

Psychiatry and Clinical Psychopharmacology September 1, 2022 DOI: 10.5152/pcp.2022.22037 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population Adult male with autism spectrum disorder and comorbid treatment-resistant mood disorder with suicidality
Intervention Ketamine
Topics Depression Esketamine Ketamine
Key findings The patient reported complete remission of depression and suicidality and reduced autism spectrum disorder symptoms after self-medicating with ketamine. The authors suggest ketamine is likely effective against depression and suicidality and potentially effective against certain autism symptoms, while cautioning about risks of unsupervised use.

Abstract

In this case report, we present an adult male patient with autism spectrum disorder and a comorbid (treatment-resistant) mood disorder with suicidality. He has been treated with numerous psychopharmaceuticals, most recently risperidone and valproic acid. He has been hospitalized several times and has attempted suicide. He displayed limited social functioning, repetitive behaviors, sensory hypersensitivity, anxiety, depressed mood, anhedonia, low energy, and chronic suicidality. Despite intensive treatment, he remained highly symptomatic and unable to work. After repeatedly self-medicating with ketamine, the patient reported that his depression and suicidality disappeared and that his autism spectrum disorder symptoms were reduced. This case study – along with previous clinical studies – suggests that ketamine is likely to be effective against depression and suicidality and potentially effective against (certain) autism spectrum disorder symptoms. However, increasing public awareness of the beneficial effects of ketamine may lead to more unsupervised and thus risky use of ketamine for self-medication.

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
Oral Administration of the NMDA Receptor Antagonist S-Ketamine as Add-On Therapy of Depression: A Case Series Four depressed patients taking standard antidepressants 2009 Case series n = 4
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

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