Intravenous ketamine for suicide ideation in borderline personality and depression.
Yara Bachir, Raymond Kassab, C. Hallal, Colin Cordahi, Charline El Hachem, R. Bou Khalil
L'Encephale August 1, 2025 DOI: 10.1016/j.encep.2025.04.008 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 24-year-old female with comorbid major depressive disorder, borderline personality disorder, posttraumatic stress disorder, and functional neurological disorder, with a history of multiple suicide attempts and treatment-resistant depression |
| Intervention | Ketamine |
| Duration | Nine intravenous ketamine sessions |
| Measures | Montgomery-Åsberg Depression Rating Scale |
| Topics | Depression Esketamine Ketamine |
| Key findings | Following nine intravenous ketamine sessions, the patient's Montgomery-Åsberg Depression Rating Scale score decreased from 45 to 11, with sustained reductions in impulsivity, irritability, and depressive symptoms. The authors argue that ketamine's rapid action on glutamate pathways may benefit complex psychiatric profiles where treatments such as electroconvulsive therapy fail, and propose a staging model emphasizing early intervention with non-classical treatments in high-risk cases. |
Abstract
Objective: This case report explores the efficacy of intravenous Ketamine in treating active suicidal ideation in a 24-year-old female with comorbid major depressive disorder (MDD), borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and functional neurological disorder (FND). CASE DESCRIPTION The patient, with a history of multiple suicide attempts and treatment-resistant MDD, demonstrated significant improvement following nine intravenous ketamine sessions. The Montgomery-Åsberg Depression Rating Scale score decreased from 45 to 11, accompanied by sustained reductions in impulsivity, irritability, and depressive symptoms.
Discussion: This report highlights ketamine's rapid action on glutamate pathways and its potential benefits in complex psychiatric profiles where traditional treatments like electroconvulsive therapy often fail. A proposed staging model for suicidal behavior management underscores the importance of early intervention with non-classical treatments in high-risk cases.
Conclusion: Intravenous ketamine offers a promising therapeutic option for patients with severe suicidality and comorbidities, warranting further research on its long-term efficacy and safety.
Comparable studies
Other case reports and case series on ketamine for depression, most cited first.