Successful Use of Ketamine for the Treatment of Psychotic Depression in a Teenager

To the Editor: Ketamine, an n-methyl-d-aspartate receptor antagonist, was first studied for its antidepressant properties in the 1990s, and is only now gaining popularity as an alternative for treatment-resistant depression in adults (Sanacora et al. 2017; Fitzgerald and O'Malley 2014). The teen, diagnosed with major depressive disorder, generalized anxiety disorder, and post-traumatic stress disorder stemming from sexual abuse, showed no benefit from initial treatment with escitalopram 20 mg/day. Patient was successfully discharged into community care 1 month after completion of ketamine infusions on the last medication regimen of venlafaxine, ziprasidone, and prazosin—with the absence of depressive, psychotic, or suicidal symptoms—and continued to do well during our follow-up of the ensuing several months.