Tratamiento Exitoso para la Depresión Grave con Riesgo Suicida en un Paciente Trasplantado de Corazón

Introduction

Major depressive disorder is related to unfavourable outcomes in patients with severe comorbidities. In transplant patients, major depression is associated with worse clinical outcomes.

Case report

We present the case of a 55-year-old man with a heart transplant due to heart failure of ischaemic origin. Six months after the transplant he developed depressed mood, anhedonia and suicidal ideation with a score of 20/27 on the PHQ-9 depression screening scale. After receiving mirtazapine 30 mg/night for a week and persisting with a high suicide risk, it was decided to administer ketamine infusion for 24 hours, with which a significant improvement in mood was observed, and the disappearance of suicidal ideation 24 hours after the infusion.

Discussion

Depression in transplant patients is a factor associated with graft loss and post-transplant mortality, in addition to favouring other negative outcomes such as deep vein thrombosis.

Conclusions

Ketamine infusion was shown to be an effective and safe option to treat major depression with suicidal risk in a heart transplant patient.