Positive Response to Ketamine Administration in Treatment Resistant Psychosis: A Case Report

Joseph Pullara, M.D.

Volume 2 Issue 1

Abstract:

The pathophysiology underlying the schizophrenia spectrum of disorders has been a topic of research for decades. Ketamine has been used as a model for psychosis for over 20 years. Treatment of refractory cases of schizophrenia and similar disorders remains a challenging aspect of psychiatry. This case report describes the case of a 45-year-old woman with treatment-refractory schizoaffective disorder who was transitioned off of clozapine due to neutropenia. This resulted in psychotic destabilization and a complicated clinical course, ultimately resulting in a re-trial of clozapine after the failure of alternative psychotropic treatment. During this trial, an MRI brain was obtained, which required a sedating dose of intravenous ketamine due to patient agitation. After just a single dose of ketamine, resolution of behavioral activation and agitation was noted for a short period, something which had not been seen in over a month of hospitalization.