KETAMINE COMBINED WITH DEXTROMETHORPHAN-BUPROPION FOR DEPRESSION IN THE CONTEXT OF NITROUS OXIDE MISUSE
International Journal of Advanced Research October 31, 2025 Sagar Sanjeev Dua, Yasmine Busaibe, Eric Wang et al.
A 27-year-old man with no prior psychiatric history developed escalating nitrous oxide use after his cousin's suicide, driven by compulsive urges despite worsening psychiatric symptoms. With his wedding two weeks away, rapid treatment combined ketamine infusion, dextromethorphan-bupropion (Auvelity), and naltrexone for craving. At follow-up, he reported abstinence from nitrous oxide, reduced irritability, and symptom improvement. The case illustrates how NMDA receptor antagonists like ketamine and nitrous oxide overlap in their effects, suggesting that clinically supervised interventions can replace maladaptive self-medication with nitrous oxide.