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Safety and efficacy of Ketamine in a patient with psychotic depression, cardiovascular disease, and starvation risk


Authors

  • Efraín Alberto Trejos Orozco Universidad Tecnológica de Pereira https://orcid.org/0000-0003-0544-4658
  • Julio César Gutiérrez Segura, Md. Universidad Tecnológica de Pereira https://orcid.org/0000-0001-9746-612X
  • Sergio Andrés Ochoa Orozco, Md. Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda. Grupo de Investigación en Salud Mental del HOMERIS, Hospital Mental Universitario de Risaralda. Pereira, Colombia https://orcid.org/0000-0002-1915-7222

DOI:

https://doi.org/10.22517/25395203.24966

Keywords:

Ketamine, Depression

Abstract

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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Author Biographies

Efraín Alberto Trejos Orozco, Universidad Tecnológica de Pereira

Estudiante de medicina. Universidad Tecnológica de Pereira.

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

Médico cirujano.

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. Grupo de Investigación en Salud Mental del HOMERIS, Hospital Mental Universitario de Risaralda. Pereira, Colombia

Médico especialista en Psiquiatría. Hospital Mental Universitario de Risaralda, Pereira, Colombia.

Docente Fundación Universitaria Autónoma de las Américas.

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Published

2022-02-14 — Updated on 2022-06-25

Versions

How to Cite

Trejos Orozco, E. A., Gutiérrez Segura, J. C., & Ochoa Orozco, S. A. (2022). Safety and efficacy of Ketamine in a patient with psychotic depression, cardiovascular disease, and starvation risk. Revista Médica De Risaralda, 28(1). https://doi.org/10.22517/25395203.24966 (Original work published February 14, 2022)