Effects of ketamine on major depressive disorder in a patient with posttraumatic stress disorder.

Ketamine has been used in anesthesia for many years and in various environments with an acceptable safety margin. The side effects of hallucinations and paranoid thoughts need to be overcome for acceptance of ketamine infusion in mainstream psychiatry. In this case report, the anesthesia department was consulted because of familiarity with the medication and the ability to modulate unacceptable side effects with its use as is done in monitored anesthesia care. It is proposed that ketamine has potential for treatment of major depression associated with posttraumatic stress disorder (PTSD) in combat veterans. This patient, who had debilitating and treatment-resistant major depression and PTSD, was treated by intravenous infusion of ketamine and experienced substantial short-term resolution of symptoms.