Rapid relief of severe major depressive disorder by use of preoperative ketamine and electroconvulsive therapy.

Major depressive disorder is a difficult-to-treat and recurrent debilitating disorder. All approved somatic treatments for major depression to date require a significant time lapse before demonstrating an antidepressant effect. However, emerging evidence indicates a potential role for the use of ketamine to rapidly relieve symptoms of major depression. We present a case of severe, recurrent major depressive disorder that demonstrated marked improvement within 8 hours of receiving a preoperative dose of ketamine and 1 treatment of electroconvulsive therapy with bitemporal electrode placement. This case is supportive of a role of ketamine in relieving symptoms of major depressive disorder rapidly and safely.