# Ketamine Therapy in Complex Cases: A Cautionary Tale of Exacerbated Personality Traits and the Crucial Role of Comprehensive Follow-Up and Psychosocial Interventions

## TL;DR

A 75-year-old woman with treatment-resistant depression experienced worsened suicidal thoughts after ketamine therapy, highlighting the need for careful treatment planning and follow-up.

## Contribution

Highlights the risk of exacerbated symptoms in complex patients and emphasizes the need for individualized mental health care.

## Key findings

- Ketamine therapy led to increased suicidal ideation in a patient with treatment-resistant depression.
- Psychosocial stressors and personality traits may influence response to ketamine.
- Comprehensive follow-up is crucial for patients with complex mental health histories.

## Abstract

This case report examines the unexpected increase in suicidal ideation following ketamine infusion therapy in a 75-year-old female with a history of treatment-resistant depression. Despite ketamine's established efficacy in treating depression and acute suicidality, this patient's condition deteriorated posttreatment. The report delves into the patient's complex background, including psychosocial stressors, genetic predisposition to depression, and a history of personality traits that may have influenced her response to ketamine. This case underscores the importance of cautious administration of ketamine, especially in patients with personality disorders, and calls for deeper understanding and individualized treatment plans in mental health care. It is a reminder of the complexities involved in treating mental health conditions and the varying effects of treatments like ketamine on different individuals.