Michael M Messer1, Irina V Haller1. 1. Dr. Messer is with Behavioral Health Department, Essentia Health, Duluth, MN, and Dr. Haller is with Essentia Institute of Rural Health, Essentia Health, Duluth, MN, USA.
Abstract
Objective: Depression is a common condition among patients with multiple sclerosis and often becomes resistant to oral antidepressants. We report a patient with multiple sclerosis who developed severe treatment-resistant depression and who was successfully treated with intravenous ketamine over the period of two years. Methods: Ketamine treatment protocol included an initial series of six treatments administered every other day, followed by a maintenance schedule. Ketamine was administered intravenously at 0.5mg/kg of ideal body weight over 40 minutes. Depression symptoms were measured using Beck Depression Index. Results: The patient's Beck Depression Index score prior to initiating ketamine treatment was 38, corresponding to severe depression. Response to treatment, defined as 50-percent reduction in Beck Depression Index score, was observed after five treatments. For this patient, the maintenance schedule ranged from a weekly treatment to one treatment every three weeks. During the two-year observation period, this patient was able to maintain a stable non-depressed mood and had no worsening of her MS symptoms. Conclusion: Ketamine may be an alternative treatment for resistant depression and may have a special use in patients with multiple sclerosis.
Objective: Depression is a common condition among patients with multiple sclerosis and often becomes resistant to oral antidepressants. We report a patient with multiple sclerosis who developed severe treatment-resistant depression and who was successfully treated with intravenous ketamine over the period of two years. Methods:Ketamine treatment protocol included an initial series of six treatments administered every other day, followed by a maintenance schedule. Ketamine was administered intravenously at 0.5mg/kg of ideal body weight over 40 minutes. Depression symptoms were measured using Beck Depression Index. Results: The patient's Beck Depression Index score prior to initiating ketamine treatment was 38, corresponding to severe depression. Response to treatment, defined as 50-percent reduction in Beck Depression Index score, was observed after five treatments. For this patient, the maintenance schedule ranged from a weekly treatment to one treatment every three weeks. During the two-year observation period, this patient was able to maintain a stable non-depressed mood and had no worsening of her MS symptoms. Conclusion:Ketamine may be an alternative treatment for resistant depression and may have a special use in patients with multiple sclerosis.
Authors: Carlos A Zarate; Jing Du; Jorge Quiroz; Neil A Gray; Kirk D Denicoff; Jaskaran Singh; Dennis S Charney; Husseini K Manji Journal: Ann N Y Acad Sci Date: 2003-11 Impact factor: 5.691
Authors: Michael Messer; Irina V Haller; Pamela Larson; Julia Pattison-Crisostomo; Charles E Gessert Journal: J Neuropsychiatry Clin Neurosci Date: 2010 Impact factor: 2.198