S-Ketamine in the treatment of depressive emergencies: a cases series of patients in a suicidal crisis
Introduction Psychiatric emergencies in Major Depressive Disorder (MDD) are characterised by multiple types of symptoms including risk of self-harm and suicidal ideation. S-ketamine intranasally (Spravato) has recently been shown to help alleviate symptoms during depressive emergencies. In this cas...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822014468/type/journal_article |
| _version_ | 1797616364304728064 |
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| author | B. Baune Z. Susam V. Falcone C. Knümann P. Sarkheil E. Kavakbasi |
| author_facet | B. Baune Z. Susam V. Falcone C. Knümann P. Sarkheil E. Kavakbasi |
| author_sort | B. Baune |
| collection | DOAJ |
| description |
Introduction
Psychiatric emergencies in Major Depressive Disorder (MDD) are characterised by multiple types of symptoms including risk of self-harm and suicidal ideation. S-ketamine intranasally (Spravato) has recently been shown to help alleviate symptoms during depressive emergencies. In this case-series, we detail the clinical effects and usability of S-ketamine applied intranasally in a psychiatric emergency setting.
Objectives
To describe the effects of S-Ketamine on depressive crises associated with suicidality and self-harm in a psychiatric emergency setting.
Methods
Patients with MDD in a psychiatric emergency were provided with intranasal S-Ketamine according to clinical indication in routine clinical care in a University inpatient setting. Clinical characteristics were assessed in a standardised manner and symptom measures were applied pre-and posttreatment. Experience with 10 patients is systematically described in this case-series.
Results
Patients had a primary diagnosis of MDD accompanied by a variety of secondary psychiatric comorbidity. Among these 10 patients, the majority were female (70 %) and the mean age was 49.5 yrs (range 26-66). All cases were considered treatment resistant and suffered severe acute suicidal ideation. Across all cases, pre-treatment MADRS was 37 on average (range 20-47) indicating a severe form of MDD. High severity was confirmed in elevated BDI scores (pre-treatment 39). Post-treatment, MADRS scores were reduced to 18 on average, alongside BDI scores (mean 24). S-ketamine administration was well-tolerated and side effects such as dissociation were of short-lived duration.
Conclusions
S-Ketamine intranasally can be safely and effectively administered in an acute psychiatric setting to treat psychiatric emergencies.
Disclosure
BTB received honoraria for consultancy and presentations from AstraZeneca, Bristol-Myers Squibb, Lundbeck, Pfizer, Servier, Wyeth, LivaNova, Janssen, Novartis, Otsuka, Angelini.
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| first_indexed | 2024-03-11T07:39:54Z |
| format | Article |
| id | doaj.art-438d258fc3f74178b2c48437ae8b4c5a |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:39:54Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-438d258fc3f74178b2c48437ae8b4c5a2023-11-17T05:08:45ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S565S56510.1192/j.eurpsy.2022.1446S-Ketamine in the treatment of depressive emergencies: a cases series of patients in a suicidal crisisB. Baune0Z. Susam1V. Falcone2C. Knümann3P. Sarkheil4E. Kavakbasi5Westfaelische-Wilhelms-University Muenster (WWU), Department Of Mental Health, Muenster, GermanyUniversity of Münster, Department Of Psychiatry, Münster, GermanyUniversity of Münster, Department Of Psychiatry, Münster, GermanyUniversity of Münster, Department Of Psychiatry, Münster, GermanyUniversity of Münster, Department Of Psychiatry, Münster, GermanyUniversity of Münster, Department Of Psychiatry, Münster, Germany Introduction Psychiatric emergencies in Major Depressive Disorder (MDD) are characterised by multiple types of symptoms including risk of self-harm and suicidal ideation. S-ketamine intranasally (Spravato) has recently been shown to help alleviate symptoms during depressive emergencies. In this case-series, we detail the clinical effects and usability of S-ketamine applied intranasally in a psychiatric emergency setting. Objectives To describe the effects of S-Ketamine on depressive crises associated with suicidality and self-harm in a psychiatric emergency setting. Methods Patients with MDD in a psychiatric emergency were provided with intranasal S-Ketamine according to clinical indication in routine clinical care in a University inpatient setting. Clinical characteristics were assessed in a standardised manner and symptom measures were applied pre-and posttreatment. Experience with 10 patients is systematically described in this case-series. Results Patients had a primary diagnosis of MDD accompanied by a variety of secondary psychiatric comorbidity. Among these 10 patients, the majority were female (70 %) and the mean age was 49.5 yrs (range 26-66). All cases were considered treatment resistant and suffered severe acute suicidal ideation. Across all cases, pre-treatment MADRS was 37 on average (range 20-47) indicating a severe form of MDD. High severity was confirmed in elevated BDI scores (pre-treatment 39). Post-treatment, MADRS scores were reduced to 18 on average, alongside BDI scores (mean 24). S-ketamine administration was well-tolerated and side effects such as dissociation were of short-lived duration. Conclusions S-Ketamine intranasally can be safely and effectively administered in an acute psychiatric setting to treat psychiatric emergencies. Disclosure BTB received honoraria for consultancy and presentations from AstraZeneca, Bristol-Myers Squibb, Lundbeck, Pfizer, Servier, Wyeth, LivaNova, Janssen, Novartis, Otsuka, Angelini. https://www.cambridge.org/core/product/identifier/S0924933822014468/type/journal_articles-ketamine depressionsuicidal ideationemergency psychiatry |
| spellingShingle | B. Baune Z. Susam V. Falcone C. Knümann P. Sarkheil E. Kavakbasi S-Ketamine in the treatment of depressive emergencies: a cases series of patients in a suicidal crisis European Psychiatry s-ketamine depression suicidal ideation emergency psychiatry |
| title | S-Ketamine in the treatment of depressive emergencies: a cases series of patients in a suicidal crisis |
| title_full | S-Ketamine in the treatment of depressive emergencies: a cases series of patients in a suicidal crisis |
| title_fullStr | S-Ketamine in the treatment of depressive emergencies: a cases series of patients in a suicidal crisis |
| title_full_unstemmed | S-Ketamine in the treatment of depressive emergencies: a cases series of patients in a suicidal crisis |
| title_short | S-Ketamine in the treatment of depressive emergencies: a cases series of patients in a suicidal crisis |
| title_sort | s ketamine in the treatment of depressive emergencies a cases series of patients in a suicidal crisis |
| topic | s-ketamine depression suicidal ideation emergency psychiatry |
| url | https://www.cambridge.org/core/product/identifier/S0924933822014468/type/journal_article |
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