Intravenous Ketamine-induced Affective Switch in a Patient of Major Depressive Disorder with Suicidal Ideation: A Case Report
Akanksha Varshney, Shravan Kumar, Ved Prakash Gupta, Rehan Mateen, Suhail Ahmad Azmi
Indian Journal of Behavioural Sciences September 26, 2022 DOI: 10.55229/ijbs.v25i2.14 (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 47-year-old man with recurrent, non-psychotic severe major depression with suicidal ideation |
| Intervention | Ketamine |
| Dose | sub-anaesthetic dosage intravenously |
| Topics | Depression Esketamine Ketamine |
| Citations | 1 |
| Key findings | A 47-year-old man with recurrent severe major depression developed a switch to mania while receiving intravenous ketamine at a sub-anaesthetic dose. The authors argue that a polarity switch should be acknowledged as a possible side effect when ketamine is used to treat depression. |
Abstract
In treatment-resistant unipolar and bipolar depression, there is increasing evidence to support the fast, although the short-lived antidepressant effect of ketamine, a non-competitive glutamate N-methyl-D-aspartate receptor antagonist. Ketamine has been shown to cause transient mood elevation or euphoria, dissociative symptoms and psychotomimetic effects when administered in unipolar or bipolar depression. Still, it has not been shown to cause an affective switch resulting in persistent hypomania/mania or a manic-like state. We report the case of a 47-year-old man who developed a switch to mania while receiving a sub-anaesthetic dosage of ketamine intravenously for his third episode of recurrent, non-psychotic severe major depression with suicidal ideation. This case indicates that a polarity switch should be acknowledged as a possible side effect when using ketamine for depression.
Comparable studies
Other case reports and case series on ketamine for depression, most cited first.