This material was presented in the 25th European Congress of Psychiatry which was organised by the European Psychiatry Association in Florence, Italy from 1-4th April 2017. I had access to the material as I attended the full Congress. Please note that this material remains the intellectual property of the European Psychiatry Association and its authors and any citation should include a full reference to it. For more information on the EPA and how to become a member, please visit: http://www.europsy.net/

1. marco.cigognini@terra.com.br
MA. Cigognini, RA. Moreno; Mood Disorders Unit (GRUDA), Institute and Department
of Psychiatry of Clinics Hospital of the University of São Paulo Medical School
INTRODUCTION: Several studies have shown that ketamine,
an antagonist of NMDA receptors, represents a promising alternative
in the treatment of depression. The therapeutic use of ketamine,
commonly used at a dose of 0.5 mg/kg, and in a single application IV
has been short and requires monitoring in a hospital setting. IM use
has been shown to be effective in treating depression and suicide risk,
and have low side-effect profile.
Intramuscular Ketamine in Depression, Suicidal Thoughts and Anxiety:
a Report On Two Case
METHODS: Two patients diagnosed with bipolar depression and
suicide risk were submitted to ketamine IM application (0.75 mg/kg),
receiving one application of ketamine IM every two days, totaling 4
applications. Patients were under medical monitoring for 2 hours after
injection verifying vital signs and potential side effects. Response were
measured using BDI, BAI and BSI.
CONCLUSIONS: The use of ketamine IM showed reduction of 75,5%-83,3%-85,7% (CASE I) and 71,4%-77,2%-60,8% (CASE II) in BDI, BAI
and BSI, respectivily as well as safety and tolerability in use.
SUMMARY: CASE 1: Female, 20 years old, single, with three recent suicide attempts, symptomatic for two months. Started Lithium 450 mg
daily. Side effects of ketamine were nausea, drowsiness and paresthesia. CASE 2: Female, 24 years old, single with symptoms lasting for six years.
Started aripiprazole 5-10 mg and 25 mg Lamotrigine concomitantly. Side effects of dry mouth, dizziness and dissociation.
AIM: To evaluate response of ketamine IM injections on depressive, suicidal and anxious symptoms.
CASE 1 CASE 2
REFERENCE:
Caddy C, Giaroli G, White TP et al; 2014. Ketamine as the prototype glutamatergic antidepressant: pharmacodynamic actions and a systematic
review and meta-analysis of efficacy. Ther Adv Psychopharmacol 4(2), 75–99.
Zanicotti CG, Perez D, Glue P; 2012. Mood and pain responses to repeat dose intramuscular ketamine in a depressed patient with advanced
cancer. J Paliat Med 15(4), 400-403.
Zanicotti CG, Perez D, Glue P; 2013. Case report: long-term mood response to repeat dose intramuscular ketamine in a depressed patient with
advanced cancer. J Paliat Med 16(7), 719-720.
Chilukuri H, Narashima PR, Pathapati RM et al; 2014. Acute antidepressant effects of intramuscular versus intravenous ketamine. Indian J
Psychiatry 36(1), 71–76.
NOT CONFLICT OF INTEREST