Exploring and treating complex trauma in everyday clinical reality in child and adolescent psychiatry

Encephale. 2025 Aug 23:S0013-7006(25)00129-0. doi: 10.1016/j.encep.2025.05.003. Online ahead of print.

ABSTRACT

OBJECTIVE: This case report explores the efficacy of intravenous (IV) Ketamine in treating active suicidal ideation in a 24-year-old female with comorbid major depressive disorder (MDD), borderline personality disorder (BPD), post-traumatic stress disorder (PTSD), and functional neurological disorder (FND).

CASE DESCRIPTION: The patient, with a history of multiple suicide attempts and treatment-resistant MDD, demonstrated significant improvement following nine IV Ketamine sessions. The Montgomery-Åsberg Depression Rating Scale score decreased from 45 to 11, accompanied by sustained reductions in impulsivity, irritability, and depressive symptoms.

DISCUSSION: This report highlights Ketamine’s rapid action on glutamate pathways and its potential benefits in complex psychiatric profiles, where traditional treatments like electroconvulsive therapy often fail. A proposed staging model for suicidal behavior management underscores the importance of early intervention with non-classical treatments in high-risk cases.

CONCLUSION: IV Ketamine offers a promising therapeutic option for patients with severe suicidality and comorbidities, warranting further research on its long-term efficacy and safety.

PMID:40850895 | DOI:10.1016/j.encep.2025.05.003