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Possible gabapentin and ketamine interaction causing prolonged central nervous system depression during post-operative recovery following cervical laminoplasty: a case report

A. Elyassi, Robert Long, Robert P. Bejnarowicz, B. Schoneboom

Journal of Medical Case Reports April 28, 2011 DOI: 10.1186/1752-1947-5-167 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population A 58-year-old African-American man with post-traumatic stress disorder and chronic pain undergoing cervical laminoplasty
Interventions Gabapentin Ketamine
Topics Depression Esketamine Ketamine
Key findings After cervical laminoplasty, the patient presented in a dissociative state with paralysis, anarthria, and preserved consciousness. All organic causes were excluded except possible prolonged central nervous system depression from a gabapentin/ketamine interaction; a new-onset conversion disorder could not be excluded. The authors state that this single case is insufficient to substantiate a true adverse reaction but warrants further investigation.

Abstract

IntroductionThe drugs gabapentin and ketamine are used frequently in the peri-operative setting. There is poor documentation whether or not gabapentin and ketamine interact to cause prolonged depression of the central nervous system.Case PresentationThe following is a case report in which a patient, a 58-year-old African-American man, with a history of post-traumatic stress disorder and chronic pain underwent a cervical laminoplasty procedure. The patient presented post-operatively in a dissociative state with paralysis, anarthria and preservation of consciousness. All organic causes were excluded, with the exception of prolonged central nervous system depression from a gabapentin/ketamine drug interaction. A new onset conversion disorder could also not be excluded.ConclusionAlthough this case by itself is not enough evidence to substantiate a true adverse reaction between gabapentin and ketamine, it is enough to warrant further investigation.

Comparable studies

Other case reports and case series on ketamine for depression, most cited first.

Study Year Design Participants
Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
Oral Administration of the NMDA Receptor Antagonist S-Ketamine as Add-On Therapy of Depression: A Case Series Four depressed patients taking standard antidepressants 2009 Case series n = 4
A longitudinal case series of IM ketamine for patients with severe and enduring eating disorders and comorbid treatment‐resistant depression Patients with enduring eating disorders and treatment-resistant depression 2021 Case series n = 4
Effects of intranasal (S)-ketamine on Veterans with co-morbid treatment-resistant depression and PTSD: A retrospective case series Veterans with co-morbid depression and PTSD 2022 Retrospective case series n = 35
Case report: Intramuscular ketamine or intranasal esketamine as a treatment in four patients with major depressive disorder and comorbid anorexia nervosa Patients with anorexia nervosa and a comorbid depressive disorder treated at a private... 2023 Case report n = 4

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