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Journal of Medical Case Reports

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Open Access 01-12-2015 | Case report

Ketamine and transcranial magnetic stimulation treatment for bipolar II disorder: a case report

Authors: Steven RD Best, Brian P Griffin, Dan G Pavel

Published in: Journal of Medical Case Reports | Issue 1/2015

Abstract

Introduction

To the best of our knowledge, this is the first case report of successful treatment for bipolar II disorder using a combined ketamine and transcranial magnetic stimulation treatment.

Case presentation

A 43-year-old Caucasian unemployed man presented to us with treatment-resistant bipolar II disorder, currently in a mixed state. A psychometric assessment and brain single-photon emission computer tomography scan were conducted at baseline. His psychometric assessment revealed severe depressive and manic symptoms that were consistent with bipolar II disorder. Findings from a brain single-photon emission computer tomography scan converged with those from his psychometric assessment. The combined ketamine and transcranial magnetic stimulation treatment was administered a total of 24 times over five months, with his ketamine dosage increased from 50mg at the first treatment to 600mg by the last. Starting after the second treatment, he reported substantial improvements in his symptoms. A follow-up psychometric assessment and brain single-photon emission computer tomography scan five months later revealed substantial blood flow increases in the previously deficient areas.

Conclusions

We provide preliminary evidence for a treatment method that magnifies the therapeutic benefits of infused ketamine along with transcranial magnetic stimulation. We postulate that this may be based on an interaction at the level of the relevant cortico-thalamo-cortical circuit(s).

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Title: Ketamine and transcranial magnetic stimulation treatment for bipolar II disorder: a case report
Authors: Steven RD Best
Brian P Griffin
Dan G Pavel
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2015
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-015-0520-0

At a glance: The STEP trials

Springer Medicine

Ketamine and transcranial magnetic stimulation treatment for bipolar II disorder: a case report

Abstract

Introduction

Case presentation

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Case presentation

Conclusions

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