Rapid antidepressant effect of S-ketamine in schizophrenia
Bartova, L., Dold, M., Kasper, S., Milenkovic, I., Papageorgiou, K., Weidenauer, A., Willeit, M., Winkler, D.
This open-label case study (n=1) describes a patient with schizophrenia whose treatment regimen was augmented with a ketamine (25mg) infusion to alleviate her symptoms of depression and suicidal ideation (SI). Her symptoms underwent a robust and sustained remission after the infusion, without any accompanying psychotic or dissociative phenomena.
Abstract
Introduction: Rapid anti-suicidal and antidepressant effects of ketamine have repeatedly been confirmed in unipolar and bipolar depression. Although meaningful antidepressant efficacy of ketamine has also been shown in depressed patients with a history of psychotic symptoms, its administration in psychotic disorders has largely been neglected due to its potential to exacerbate dissociative or psychotic symptoms.Methods: Presenting a case of a young female inpatient suffering from schizophrenia with severe post-psychotic depression, we demonstrate a robust anti-suicidal and antidepressant effect of S-ketamine infusions administered thrice weekly for 3 weeks in total.Results: Importantly, no relevant psychotic or dissociative symptoms occurred during the whole augmentation treatment period leading to sustained remission of depressive symptoms and suicidality.Discussion: Our safe and effective experience with intravenous S-ketamine might encourage researchers and clinicians to widen its administration range beyond the diagnosis of depression to enrich the current knowledge of ketamine effects in psychotic disorders.