Ketamine for Traumatic Assault-Induced Depression: A Case Report
Caitlyn B. Coffelt, Kyle Gibson, Jason VanLandingham
Journal of Trauma Nursing November 1, 2023 DOI: 10.1097/jtn.0000000000000755 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 68-year-old female trauma patient with no significant medical history of psychiatric disorders who developed severe depression after an assault |
| Intervention | Ketamine |
| Dose | 0.5 mg/kg |
| Duration | Monitored for 24 hr after ketamine infusion |
| Measures | Montgomery–Asberg Depression Rating Scale (MADRS) |
| Topics | Depression Esketamine Ketamine |
| Key findings | In a 68-year-old woman who developed severe depression after a traumatic assault, a single intravenous ketamine infusion (0.5 mg/kg over 40 minutes) was followed by a fall in MADRS score from 37 to 16 within 4 hours and to 4 at 24 hours, indicating remission. The authors present this as an account of ketamine's potential benefit as a rapid treatment of depression in an adult trauma patient. |
Abstract
Background: This case report describes the use of ketamine as a rapid, effective treatment of depression in a 68-year-old female patient with no significant medical history of psychiatric disorders. Patients who experience intentional or unintentional traumas are at an increased risk for developing depression or posttraumatic stress disorder, and emerging evidence has supported the use of ketamine as an alternative treatment of depression. CASE PRESENTATION: This is the case of a 68-year-old female patient who was assaulted, resulting in multiple stab wounds to both hands and the right upper quadrant. She underwent placement of a chest tube and surgical repair of the liver and was subsequently admitted to the intensive care unit. These events led to the development of severe depression symptoms, as evidenced by a Montgomery–Asberg Depression Rating Scale (MADRS) score of 37. As treatment of her acute depression, the patient received a single intravenous dose of ketamine (0.5 mg/kg) infused over 40 min and was monitored for side effects. The MADRS is a 10-item depression screening tool that assesses symptoms and changes over time. Within 4 hr of receiving ketamine, the patient reported a significant improvement in her mood and her MADRS score decreased to 16, classifying this patient as experiencing mild depression. The patient continued to improve, and 24 hr after receiving ketamine, her MADRS score was 4, indicating remission of her depression symptoms.
Conclusion: This case report aims to provide an account of the potential benefits of ketamine as a rapid treatment of depression in an adult trauma patient.