Intravenous ketamine therapy in a patient with a treatment-resistant major depression.

Swiss Med Wkly. 2007 Apr 21;137(15-16):234-6. Intravenous ketamine therapy in a patient with a treatment-resistant major depression. Liebrenz M, Borgeat A, Leisinger R, Stohler R. Click [url=http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3671&itool=AbstractPlus-def&uid=17525879&db=pubmed&url=http://www.smw.ch/dfe/set_archiv.asp?target=2007/15/smw-11852]here[/url] for full text version Psychiatric University Hospital, Research Group on Substance Use Disorders, Zurich, Switzerland. Michael.Liebrenz@puk.zh.ch [b]BACKGROUND:[/b] Recently, reports from North America have indicated that the intravenous infusion of ketamine hydrochloride (an N-methyl-d-aspartate receptor antagonist) results in a sudden and robust improvement of depression symptoms. [b]OBJECTIVE:[/b] To corroborate antidepressant effectiveness of IV ketamine in a patient with a co-occurring substance use disorder for the first time in a European clinical setting. [b]DESIGN: [/b]Open label trial Methods: A 55-year-old male subject with a treatment-resistant major depression and a co-occurring alcohol and benzodiazepine dependence received an intravenous infusion of 0.5 mg/kg ketamine over a period of 50 minutes. Effects were assessed by means of a clinical interview, the 21-item Hamilton Depression Rating scale (HDRS), and the 21-item Beck Depression Inventory (BDI) at baseline, 1 hour, 1 day, 2 days, and 7 days after intervention. [b]RESULTS[/b]: Following the administration of ketamine the subject experienced a significant improvement of his symptoms peaking on the 2nd day post infusion (HDRS from 36 to 16; -56.6%, BDI from 26 to 9; -65.4%). The subject first reported improvements 25 min. into the infusion and continued to describe positive effects throughout the subsequent 7 days. CONCLUSION: Ketamine not only seems to have strong antidepressant effects but also to act very swiftly. These actions were unaffected by an alcohol or benzodiazpine dependence.