We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Subanesthetic Ketamine Infusion Reducing Symptoms of Depression in a Patient With End-Stage Heart Failure Enrolled in Hospice Care: A Case Report.
- Authors
Kaur, Tejaspreet; Sharma, Kavita; Groban, Leanne
- Abstract
Background: The development of major depressive disorder in patients at end of life often goes undiagnosed, as it is difficult to distinguish from preparatory grief and/or hypoactive delirium in this unique patient population. If this preliminary barrier of appropriate diagnosis is overcome, it can be quite difficult to properly select and adjust pharmacological therapy. Many well-established antidepressants take four to five weeks for maximal effectiveness (which may be far too long of a titration period for patients at end of life), have various contraindications to patients' comorbid chronic conditions (particularly patients with cardiovascular disease), or may simply be ineffective. Case: We present a case report of severe treatment-resistant depression in an end-stage heart failure patient enrolled in hospice care. Discussion: We discuss the potential use of a single low-dose intravenous racemic ketamine infusion to reduce end-of-life suffering related to depression, despite the theoretical contraindication of ketamine use in such patients, in part, due to its sympathomimetic secondary effect.
- Subjects
PREVENTION of mental depression; HOSPICE care; GRIEF; ANTIDEPRESSANTS; TERMINAL care; SYMPATHOMIMETIC agents; SEROTONIN uptake inhibitors; CARDIOVASCULAR diseases; PALLIATIVE medicine; KETAMINE; MENTAL depression; CASE studies; DELIRIUM; SUBCUTANEOUS infusions; HEART failure
- Publication
Journal of Palliative Medicine, 2023, Vol 26, Issue 10, p1435
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2022.0430