Intranasal esketamine use in bipolar disorder: A case report
Courtney Skriptshak, Ashley Reich
Mental Health Clinician July 1, 2021 DOI: 10.9740/mhc.2021.07.259
Summary
AI-generated from the abstractIntranasal esketamine, FDA-approved for treatment-resistant depression and major depressive disorder with suicidal ideation, has not been studied in bipolar disorder. Antidepressants can induce rapid cycling in bipolar patients, but this case report suggests that intranasal esketamine combined with mood stabilizer therapy may be safe for a bipolar patient without recent manic or hypomanic episodes.
Study at a glance
| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Patient diagnosed with bipolar disorder without recent history of manic or hypomanic episodes |
| Interventions | intranasal esketamine mood stabilizer therapy |
| Citations | 11 |
| Key finding | Intranasal esketamine in combination with mood stabilizer therapy may be safe in a patient with bipolar disorder without recent manic or hypomanic episodes. |
Abstract
Abstract Over the past few years, intranasal esketamine has been FDA-approved for treatment-resistant depression as well as MDD with suicidal ideation. In the clinical trials leading to the recent FDA approvals, subjects with a diagnosis of bipolar disorder were excluded from participation in the trial. The manufacturer of intranasal esketamine states that it “has not been studied, and is not indicated, for patients with bipolar disorder.” Antidepressants are commonly associated with having the potential to induce rapid cycling in patients with bipolar disorder, though the mechanism is not fully understood. This case report demonstrates the potential safety of intranasal esketamine in combination with mood stabilizer therapy in a patient diagnosed with bipolar disorder without recent history of manic or hypomanic episodes.