Possible Affective Switch Associated With Intravenous Ketamine Treatment in a Patient With Bipolar I Disorder

      A collaborative team of doctors and nurses from the Departments of Psychiatry and Anesthesiology at Kaiser Permanente started the Ketamine Infusion Therapy Program for treatment of unipolar and bipolar depression in fall 2014. We have treated 40 patients with both diagnoses since inception of the program, and we have observed one possible ketamine-induced case switch from depression to mixed mania among seven patients with bipolar disorder (n = 4 bipolar disorder type II and n = 3 bipolar disorder type I) treated. We report this case here.
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      • Interaction of Ketamine and Cannabis in Bipolar Disorder
        Biological PsychiatryVol. 79Issue 9
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          I read with great interest a recent correspondence by McInnes et al. (1) regarding a possible switch from depression to mania/mixed state in a woman with bipolar disorder type I. Briefly, the authors found that the 44-year-old patient treated with various outpatient medications (lithium 600 mg, aripiprazole 10 mg, modafinil 100 mg, clonazepam 1 mg, and zolpidem 10 mg, and lorazepam .5 mg on demand) developed an affective switch following a single 40-minute continuous intravenous infusion of ketamine .5 mg/kg.
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