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Life sciences · Journal article
Bangladesh Journal of Psychiatry · October 5, 2026
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Depressive episodes are common but has great impact either in unipolar or bipolar mood disorder. Medical management of severe depression with suicidal attempts are challenging. The rate of Major Depressive Disorder (MDD) who are non-responders are about 30% of those receiving treatment in research settings. Over the past 15 years, ketamine infusions have demonstrated rapid antidepressant and anti-suicidal effects in patients with MDD, with 71% experiencing a 50% or greater reduction in the severity of suicidal ideation on the first day. Despite these promising outcomes, there is limited knowledge about the likelihood of responses to ketamine in real world settings. In this case series, six patients aged 24-36 with severe MDD with suicidal ideations and/ thoughts were treated with intravenous ketamine therapy. Each subject received a subanesthetic dose of 0.5 mg/kg of ketamine diluted with 50ml distilled water administered intravenously over 40 minutes in a micro burette and delayed more when there are side effects if any, under supervision of anesthetist in High Dependency Unit (HDU). A modified scale for suicidal ideation (MSSI) was used for psychometric assessment. Of the six patients, five were treatment resistant depression (TRD) and one with severe MDD with suicidal thoughts and non-adherence to treatment. Three of the six patients responded positively to the acute infusion phase, while three did not, highlighting the variability in individual responses to ketamine therapy. This case series underscores the complexity of treating patients with treatment-resistant depression and emphasizes the need for personalized therapeutic approaches. Bang J Psychiatry 2024;38(1): 19-25