Ketamine Role in Schizoaffective Disorder Depressive Type

Walid Aziz, Crystal Babb, Darin R Brown, Ahmad Murtaza Exeer, Partam Manalai
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引用次数: 1

Abstract

Ketamine use for patients with severe treatment-resistant depression continues to be an area of interest due to the relatively limited number of treatment options for those patients. Although its use as a treatment option for patients with schizophrenia and schizoaffective disorder may seem counterintuitive, in this case report, we explore the efficacy of ketamine for depressive episodes in schizoaffective disorder. This patient who carried a diagnosis of schizoaffective disorder was given 300 mg of intramuscular ketamine for agitation. However, over the course of four days of inpatient stay, her depression drastically improved. She met criteria for remission with the Hamilton Rating Scale for Depression (HAM-D) score of 4, down from an initial score of 21. We advocate for a better understanding of the pros and cons of using ketamine for depression in schizoaffective disorders considering the controversy over the diagnosis of schizoaffective disorder, especially in African American population. At the urging of reducing the risk of suicide among this group and improving their quality of life as well as reducing financial burden by shortening total duration of hospitalization, it may be worthwhile to explore the feasibility of ketamine as a treatment option for severe depression in these patients, possibly as a last resort.
氯胺酮在分裂情感性障碍抑郁型中的作用
严重难治性抑郁症患者使用氯胺酮仍然是一个令人感兴趣的领域,因为这些患者的治疗选择相对有限。虽然氯胺酮作为精神分裂症和分裂情感性障碍患者的治疗选择似乎违反直觉,但在本病例报告中,我们探讨了氯胺酮对分裂情感性障碍抑郁发作的疗效。这个患有分裂情感性障碍的病人被给予300毫克肌内氯胺酮治疗躁动。然而,在四天的住院治疗过程中,她的抑郁症明显好转。她符合汉密尔顿抑郁量表(HAM-D)的缓解标准,从最初的21分下降到4分。考虑到分裂情感性障碍的诊断存在争议,特别是在非洲裔美国人群中,我们提倡更好地了解使用氯胺酮治疗分裂情感性障碍抑郁症的利弊。为了降低这一群体的自杀风险,提高他们的生活质量,并通过缩短住院总时间来减轻经济负担,探索氯胺酮作为这类患者重度抑郁症的治疗选择的可行性,可能是最后的手段,是值得的。
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