title: Ketamine Therapy for Treatment-resistant Depression in a Patient with Multiple Sclerosis: A Case Report.
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.
authors.affiliation: 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.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Messer
authors.affiliation: 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.
authors.forename: Irina V
authors.initials: IV
authors.lastname: Haller
keywords: Multiple sclerosis; electroconvulsive therapy; ketamine; major depressive disorder; treatment-resistant depression