This episode tackles the profound challenge of treatment-resistant depression (TRD), a severe mental illness affecting 280 million people globally. While low-dose subanesthetic intravenous ketamine treatment has shown rapid improvement for TRD, its effects are often transient, lasting only days to weeks, and IV administration can be impractical and expensive for long-term use.

We shift focus to a novel, more accessible approach: very low-dose subcutaneous ketamine. Drawing on a unique case report, we explore its potential as a maintenance option for severe TRD. This method is highlighted for being less invasive, more cost-effective, practical, and accessible, potentially offering a more gradual absorption that could decrease adverse effects. The case study featured a patient with severe TRD who, after 15 years of struggle, achieved a stable mental state and maintained occupational functioning for four years with subcutaneous ketamine.

Study discussed: Can, A. T., Hermens, D. F., & Lagopoulos, J. (2022). A unique case of very low-dose subcutaneous ketamine use: Maintenance option of ketamine for treatment-resistant depression. Clinical Case Reports, 10(12), e6675. https://doi.org/10.1002/ccr3.6675