Safety and efficacy of ketamine-augmented electroconvulsive therapy in third trimester pregnancy complicated by COVID-19
Ashmi Patel, Anna Saucier, C. Hobday, R. Chacko
Proceedings August 8, 2022 DOI: 10.1080/08998280.2022.2106415 (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 35-year-old pregnant woman with treatment-resistant major depressive disorder and suicidal ideation |
| Interventions | Electroconvulsive therapy (ECT) Ketamine |
| Duration | Eight-treatment course of ECT |
| Measures | PHQ-9 |
| Topics | Esketamine Ketamine |
| Key findings | An eight-treatment course of electroconvulsive therapy augmented with ketamine was followed by a large reduction in depression severity in a pregnant patient with treatment-resistant depression and suicidal ideation, with her PHQ-9 score falling from 22/27 to 4/27. The authors present this as a case supporting ECT with ketamine in this population. |
Abstract
Abstract Major depressive disorder during pregnancy can be detrimental to the fetus and patient. Treatments can include electroconvulsive therapy (ECT) for severe cases. The use of ketamine in ECT can provide symptomatic relief as well as induce anesthesia. Here, we describe the case of a 35-year-old gravid woman with a long-standing history of major depressive disorder who presented with treatment-resistant depression with suicidal ideation after an alteration in her antidepressant medication. After psychiatric evaluation, she was deemed to be a good candidate for ECT augmented with ketamine for symptomatic relief. This was complicated by an positive but asymptomatic COVID-19 status. Despite these factors, the patient experienced significant relief after an eight-treatment course of ECT, with a reduction of her PHQ-9 score from 22/27 to 4/27 points.
Comparable studies
Other case reports and case series on ketamine, most cited first.