Eficacia y seguridad de la Ketamina en una paciente con depresión, síntomas psicóticos, enfermedad cardiovascular y riesgo de inanición


Autores/as

DOI:

https://doi.org/10.22517/25395203.24966

Palabras clave:

Ketamine, Depression

Resumen

Introduction: There has been a rising interest in ketamine as a promising treatment for refractory depression. Despite this, there is uncertain knowledge regarding aspects of the routinary use of ketamine for treating depression, such as optimal doses, long term toxicity, abuse potential in depressed patients, probable adverse effects associated with antidepressant drugs, the indication of ketamine in psychotic patients, and the ethical concerns of ketamine use.

Clinical case: A 63 year-old woman with a psychotic depressive episode, catatonic features, cardiovascular disease (patent foramen ovale and atrial fibrillation) , and starvation risk because she refused food intake. She was sent to electroconvulsive therapy (ECT) after several weeks of oral administration of benzodiazepine, antipsychotic, and antidepressant medications; the patient presented no improvement, but she was rejected due to her cardiovascular comorbidity. Two IV Ketamine doses were used as a life-saving strategy with good clinical response, mainly in terms of the catatonic features. The ketamine treatment was not only effective but also well tolerated.

Discussion: Despite the little information regarding its use in psychotic and catatonic patients, this case would suggest that it remains effective and safe, as well as a good option for patients with cardiovascular disease and those who cannot use electroconvulsive therapy.

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Biografía del autor/a

Efraín Alberto Trejos Orozco, Universidad Tecnológica de Pereira

Estudiante de medicina

Julio César Gutiérrez Segura, Md., Universidad Tecnológica de Pereira

Médico

Especialista en psiquiatría

Especialista en psiquiatría de enlace

Docente titular, Universidad Tecnológica de Pereira

 

Sergio Andrés Ochoa Orozco, Md., Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda

Médico

Especialista en psiquiatría

Docente, Fundación Universitaria Autónoma de las Américas

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Publicado

2022-02-14 — Actualizado el 2022-06-30

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Cómo citar

Trejos Orozco, E. A., Gutiérrez Segura, J. C., & Ochoa Orozco, S. A. (2022). Eficacia y seguridad de la Ketamina en una paciente con depresión, síntomas psicóticos, enfermedad cardiovascular y riesgo de inanición. Revista Médica De Risaralda, 28(1). https://doi.org/10.22517/25395203.24966 (Original work published 14 de febrero de 2022)

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Sección

Reporte de caso