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Induction of Prolonged Mania During Ketamine Therapy for Reflex Sympathetic Dystrophy

      Clinical studies have demonstrated that ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has mood-elevating and antidepressant properties (
      • Berman R.M.
      • Cappiello A.
      • Anand A.
      • Oren D.A.
      • Heninger G.R.
      • Charney D.S.
      • et al.
      Antidepressant effects of ketamine in depressed patients.
      ,
      • Zarate Jr, C.A.
      • Singh J.B.
      • Carlson P.J.
      • Brutsche N.E.
      • Ameli R.
      • Luckenbaugh D.A.
      • et al.
      A randomized trial of an N-methyl-d-aspartate antagonist in treatment-resistant major depression.
      ,
      • Anand A.
      • Charney D.S.
      • Oren D.A.
      • Berman R.M.
      • Hu X.S.
      • Cappiello A.
      • et al.
      Attenuation of the neuropsychiatric effects of ketamine with lamotrigine: support for hyperglutamatergic effects of N-methyl-d-aspartate receptor antagonists.
      ,
      • Diazgranados N.
      • Ibrahim L.
      • Brutsche N.E.
      • Newberg A.
      • Kronstein P.
      • Khalife S.
      • et al.
      A randomized add-on trial of an N-methyl-d-aspartate antagonist in treatment-resistant bipolar depression.
      ,
      • Krystal J.H.
      • Karper L.P.
      • Seibyl J.P.
      • Freeman G.K.
      • Delaney R.
      • Bremner J.D.
      • et al.
      Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans: Psychotomimetic, perceptual, cognitive, and neuroendocrine responses.
      ,
      • aan het Rot M.
      • Collins K.A.
      • Murrough J.W.
      • Perez A.M.
      • Reich D.L.
      • Charney D.S.
      • et al.
      Safety and efficacy of repeated-dose intravenous ketamine for treatment-resistant depression.
      ). In light of these findings, we present a case report of a patient receiving ketamine therapy for reflex sympathetic dystrophy who subsequently developed manic and psychotic symptoms.
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        Antidepressant effects of ketamine in depressed patients.
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