The glutamate N-methyl-D-aspartate (NMDA) receptor antagonist ketamine may exhibit antidepressant effect. Previous studies of treatment-resistant depression reveal that ketamine infusions may result in a rapid antidepressant response with improvement usually sustained for several days. This case suggests that intravenous administration of ketamine may be effective for immediate relief from symptoms in unipolar depression and may also relieve suicidal ideation. Due to the prolonged period between the initiation of treatment and the onset of action of currently available antidepressants, only a few things can be done for the management of acute and severe suicidal ideation other than close monitoring or hospitalization. Rapid effect of ketamine may be an advantage in the management of suicide risk. Although additional research is needed to ascertain optimal dosing schedules and route of administration of ketamine, NMDA agents warrant further investigation as a treatment option in treatment-resistant depression and as an agent intended to reduce suicides.
Key words: depression, ketamine, suicide, treatment resistance
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