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.
An 86-year-old man with long-standing complex regional pain syndrome (CRPS) causing back and leg pain had not improved with opioids or duloxetine, and religious beliefs limited standard hospital care. After one intravenous ketamine infusion, he showed immediate and substantial improvements in pain intensity, mood, and mobility. The case highlights the importance of culturally sensitive, patient-centered care and suggests ketamine may help treat CRPS when traditional therapies fail.