Long-Term Ketamine Self-Injections in Major Depressive Disorder: Focus on Tolerance in Ketamine's Antidepressant Response and the Development of Ketamine Addiction

Journal of Psychoactive Drugs
Udo Bonnet

Abstract

Sub-anaesthetic ketamine is of special interest for depression research due to its rapid and potent but short-lived antidepressant response (after-effect). The presented case is the first one in the literature which deals in detail with the transfer from ketamine's antidepressant action to ketamine addiction. A 50-year-old anaesthetic nurse, who had never been treated with antidepressants before, started with self-injecting ketamine racemate 50 mg IM once a week to cope with her major depression. She continuously stole ketamine from hospital stocks. Due to a gradually developing tolerance to ketamine's antidepressant action, she stepwise increased dose and frequency of ketamine self-injections up to daily 2 g IM (three-fold her anaesthetic dose) over six months. This was accompanied by the development of ketamine addiction, loss of consciousness, dissociative immobility, and amnesia. Inpatient detoxification treatment was characterized by a strong craving for ketamine and, later on, by the occurrence of a severe depressive episode remitting on venlafaxine. A 14-week follow-up documented a normal condition without any ketamine sequelae, such as craving, psychosis, depression, or cognitive abnormalities. Thus, awareness of ketami...Continue Reading

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Citations

Nov 12, 2016·Life Sciences·Udo Bonnet
Jun 29, 2018·The Australian and New Zealand Journal of Psychiatry·Michael BerkBrian H Harvey
Mar 20, 2019·Der Schmerz·Rae Frances Bell, Eija Anneli Kalso
Dec 15, 2015·The Medical Journal of Australia·Colleen Loo
Dec 12, 2018·Pain Reports·Rae Frances Bell, Eija Anneli Kalso
Nov 3, 2016·The British Journal of Psychiatry : the Journal of Mental Science·Udo Bonnet
Oct 2, 2020·Critical Care Nurse·Kyle Brown, Calvin Tucker
Dec 12, 2020·Journal of Affective Disorders·Jolien K E VeraartRobert A Schoevers
Mar 13, 2021·Frontiers in Pharmacology·Clayton CulpSalahadin Abdi
Nov 10, 2020·Neuroscience Letters·Milene BorsoiGilda A Neves
Jun 29, 2021·Journal of Psychiatric Research·Ifat Israel-ElgaliNoam Shomron

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