Intravascular ketamine infusion for the treatment of chronic pain and depression. Case report

ABSTRACT BACKGROUND AND OBJECTIVES: Chronic pain and depression are two comorbidities that correlate at the molecular level in the central nervous system and cause sufering to the patient, being dificult to be managed. In recent years, several studies have shown significant analgesic and antidepressant efects from intravascular infusion of ketamine, being a promising alternative option for refractory patients. Tus, the aim of the study was to report the case of a patient with refractory chronic pain and depression submitted to serial ketamine single dose infusions. CASE REPORT: Female patient, 33 years old, diagnosed with interstitial cystitis 13 years ago with refractory chronic pain and depression, submitted to serial infusions of intravascular ketamine. Tree serial infusions were performed, providing a significant improvement in pain and mood. However, the patient could not tolerate the adverse efects, particularly, the transient sensation of impending death and panic attack, and abandoned the treatment. CONCLUSION: Ketamine is a safe and promising treatment option for chronic pain and depression and can promote significant, albeit transient, pain and mood relief using subanesthetic dosage. However, its adverse efects can be an important limitation for therapeutic success. Standardized clinical studies are needed to better understand the relationship between chronic pain and depression and to establish the best therapeutic approach.