Use of Repeated Intravenous Ketamine Therapy in Treatment-Resistant Bipolar Depression With Suicidal Behavior

Introduction

An article Use of Repeated Intravenous Ketamine Therapy in Treatment-resistant Bipolar Depression with Suicidal Behavior: a Case Report from Spain describes the efficacy of ketamine as a treatment for bipolar depression with signs of suicide (López-Díaz, et al., 2017).

Main effects of ketamine

The authors point out that “ketamine is mainly popular among anesthesiologists and in pediatrics, but its use is accompanied by psychomimetic and dissociative side effects” (López-Díaz, et al., p.137). This effect of ketamine is now being used as a drug of abuse. According to their article, repeated Use of ketamine is much more effective than a single injection (López-Díaz, et al., 137). However, the goal and objective of the study were to determine how to maintain the high efficiency of ketamine throughout the patient’s treatment. It is also indicated that after four weeks of progress, the patient’s condition deteriorated dramatically, and treatment was interrupted (López-Díaz, et al., 138). For this reason, the authors question how to stabilize a patient’s condition with ketamine (López-Díaz, et al., 137).

The author of the article Effects on Suicidal Ideation and Possible Use as Crisis Intervention in Patients at Suicide Risk refers to the article Use of Repeated Intravenous Ketamine Therapy to study the effect of ketamine on patients at high suicide risk (Andrade). In his article, Andrade points out that “ketamine is highly effective after one use and continues to be effective for one week” (1), although López-Díaz, et al. say that “after one use the effect is not as high” (138). Also, the article Effects on Suicidal Ideation states that improvements are visible within patients with both mild and severe suicidal conditions (2).

However, López-Díaz, et al., in their article, mentioned an example of a 40-year-old patient with severe depressive disorder, that showed that even with multiple injections of ketamine, the patient’s condition was unstable and deteriorated sharply (138). Andrade may have exaggerated the efficacy and positive effects of ketamine on patients slightly, given that it did not indicate side effects or drug effects of the medicine.

Conclusion

Analyzing the article Effects on Suicidal Ideation, it can be concluded that its author has considered only those aspects of the study by López-Díaz, et al. that could be beneficial to him.

References

Andrade, Chittaranjan. “Ketamine for depression, 6: effects on suicidal ideation and possible use as crisis intervention in patients at suicide risk.” The Journal of Clinical Psychiatry, vol. 79, no. 2, 2018.

López-Díaz, Álvaro, et al. “Use of repeated intravenous ketamine therapy in treatment-resistant bipolar depression with suicidal behavior: a case report from Spain.” Therapeutic Advances in Psychopharmacology, vol. 7, no. 4, 2017, pp. 137-140.