Citation

Arango-Posada MDM, Prada-Escobar AI, Marín-Hernández C, Monsalve-Franco V, Restrepo-Bernal D. Rev. Colomb. Psiquiatr. (Engl. Ed.) 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, Asociación Colombiana de Psiquiatría, Publisher Elsevier Publishing)

DOI

10.1016/j.rcpeng.2022.03.001

PMID

39127545

Abstract

INTRODUCTION: Major depressive disorder is related to unfavourable outcomes in patients with severe comorbidities. In transplant patients, major depression is associated with worse clinical outcomes. CASE REPORT: We present the case of a 55-year-old man with a heart transplant due to heart failure of ischaemic origin. Six months after the transplant he developed depressed mood, anhedonia and suicidal ideation with a score of 20/27 on the PHQ-9 depression screening scale. After receiving mirtazapine 30 mg/night for a week and persisting with a high suicide risk, it was decided to administer ketamine infusion for 24 h, with which a significant improvement in mood was observed, and the disappearance of suicidal ideation 24 h after the infusion.

DISCUSSION: Depression in transplant patients is a factor associated with graft loss and post-transplant mortality, in addition to favouring other negative outcomes such as deep vein thrombosis.

CONCLUSIONS: Ketamine infusion was shown to be an effective and safe option to treat major depression with suicidal risk in a heart transplant patient.

Language: es

Keywords

Depressive disorder; Suicide risk; Ketamine; Heart transplantation; Ketamina; Riesgo suicida; Trasplante de corazón; Trastorno depresivo