[Ketamine administration in case of severe, therapy resistant depressed patient, case report].
Szabolcs Morvai, Attila István Nagy, Adrienn Bálint-Szöllősi, E Csaba Móré, Roland Berecz, Ede Frecska
Ideggyogyaszati szemle November 30, 2016 DOI: 10.18071/isz.69.0421 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Randomized Placebo-controlled Double-blind Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | One female patient with treatment-resistant severe depression |
| Intervention | Ketamine |
| Dose | 0.5 mg/kg of body weight administered intravenously over 40 minutes |
| Duration | Two infusions 15 days apart |
| Measures | Hamilton Depression Rating Scale 21 items, Hamilton Anxiety Rating Scale, Beck Depression Inventory |
| Topics | Depression Ketamine Esketamine |
| Keywords | Biological treatments |
| Key findings | Two intravenous ketamine infusions of 0.5 mg/kg produced rapid improvement in a woman with treatment-resistant depression: Hamilton Depression Rating Scale scores dropped from 28 to 8, Hamilton Anxiety Rating Scale from 25 to 6, and Beck Depression Inventory from 20 to 9, with no severe adverse events and only a brief mild dissociative state. |
Abstract
Objective - In our case report we present the treatment of a female patient suffering from therapy resistant depression. This procedure is not in practice in Hungary at present, the aim of our work to reproduce the findigs of international studies in domestic circumstances. Matter - Major depression is a common, chronic and severe mental disorder, with 16.2% lifetime prevalence. Many international randomized, placebo controlled trials found administration of ketamine infusion effective in depressed patients. Methods - Since ketamine is an anesthetic agent, its administration was performed in the post-operative monitoring room of our hospital operating-room, supervised by an anesthesiologist. According to formerly published data, a dose of 0.5 mg/kg of body weight was administered intravenously in 40 minutes by perfusor. The drug was administered in a same manner fifteen days later. Subject - The patient was admitted to our inpatient ward with severe depression. During two months of combined antidepressant therapy her condition has not improved significantly. Approval for off label drug indication was granted with urgency by the National Institute of Quality and Organizational Development in Healthcare and Medicines. Results - During the two treatments the Hamilton Depression Rating Scale 21 items rating scale score was reduced to 8 from the baseline 28, the Hamilton Anxiety Rating Scale score was reduced to 6 from 25, Beck Depression Inventory was reduced to 9 from 20. Upon administration of the drug no severe adverse event was detected, the mild dissociative state related to ketamine was ceased in a short period of time. Discussion - With administration of 0.5 mg/kg ketamine the authors managed to achieve rapid improvement in a therapy resistant depressed patient, without permanent side effects. Our future plan is to repeat the use of the drug within a double-blind, placebo controlled trial in order to prove its efficacy in hospital settings.
Comparable studies
Other case reports and case series on ketamine for depression, most cited first.