Ketamine cystitis following ketamine therapy for treatment-resistant depression - case report.

Cystitis KIC Ketamine Lower urinary tract symptoms Treatment-resistant depression

Journal

BMC psychiatry

ISSN: 1471-244X

Titre abrégé: BMC Psychiatry

Pays: England

ID NLM: 100968559

Informations de publication

Date de publication:
02 Jan 2024

Historique:

received: 04 07 2023

accepted: 18 12 2023

medline: 4 1 2024

pubmed: 4 1 2024

entrez: 3 1 2024

Statut: epublish

Résumé

Ketamine is a novel and exciting putative antidepressant medication for patients with treatment-resistant depression. A complication commonly seen in frequent and heavy recreational use of ketamine is ulcerative cystitis, which presents with lower urinary tract symptoms (LUTS) and upper renal tract damage and can be seen in over 25% of regular users. Although Ketamine-induced cystitis (KIC) is a recognised complication in recreational use of ketamine, its occurrence in therapeutic use of ketamine in depression has so far not been reported. The exact pathogenesis of KIC is currently unknown, making treatment and prevention advice much more difficult. Early diagnosis of KIC and immediate cessation of ketamine has been shown to improve adverse urinary tract symptoms and prevent further damage. We present a case of a 28-year-old female who was started on ketamine treatment for depression, and who then developed symptoms of KIC, which was confirmed by urine microscopy, culture and analysis. To our knowledge, this is the first reported case of KIC in a patient receiving treatment-dose ketamine as part of their antidepressant therapy.

Sections du résumé

BACKGROUND BACKGROUND

CASE PRESENTATION METHODS

We present a case of a 28-year-old female who was started on ketamine treatment for depression, and who then developed symptoms of KIC, which was confirmed by urine microscopy, culture and analysis.

CONCLUSIONS CONCLUSIONS

To our knowledge, this is the first reported case of KIC in a patient receiving treatment-dose ketamine as part of their antidepressant therapy.

Identifiants

DOI: 10.1186/s12888-023-05468-3 PMID: 38166893

pubmed: 38166893

doi: 10.1186/s12888-023-05468-3

pii: 10.1186/s12888-023-05468-3

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

Informations de copyright

Références

Zarate CA, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, Charney DS, Manji HK. A Randomized Trial of an N-methyl-D-aspartate antagonist in treatment-resistant Major Depression. Archives of General Psychiatry [online]. 2006;63(8):856. https://doi.org/10.1001/archpsyc.63.8.856 .

doi: 10.1001/archpsyc.63.8.856 pubmed: 16894061

Bahji A, Vazquez GH, Zarate CA. Comparative efficacy of racemic ketamine and esketamine for depression: a systematic review and meta-analysis. J Affect Disord. 2020;278:12473. https://doi.org/10.1016/j.jad.2020.09.071 .

doi: 10.1016/j.jad.2020.09.071

Winstock AR, Mitcheson L, Gillatt DA, Cottrell AM. The prevalence and natural history of urinary symptoms among recreational ketamine users. BJU Int. 2012;110(11):1762–6. https://doi.org/10.1111/j.1464-410x.2012.11028.x .

doi: 10.1111/j.1464-410x.2012.11028.x pubmed: 22416998

Huang Y-C, Jeng C-M, Cheng T-C. Ketamine-associated Ulcerative Cystitis. Tzu Chi Medical Journal. 2008;20(2):144–6. https://doi.org/10.1016/s1016-3190(08)60026-9 .

doi: 10.1016/s1016-3190(08)60026-9

Yek J, Sundaram P, Aydin H, Kuo T, Ng L. The clinical presentation and diagnosis of ketamine-associated urinary tract dysfunction in Singapore. Singapore Med J. 2015;56(12):660–5. https://doi.org/10.11622/smedj.2015185 .

doi: 10.11622/smedj.2015185 pubmed: 26702160 pmcid: 4678404

Anderson DJ, Zhou J, Cao D, McDonald M, Guenther M, Hasoon J, Viswanath O, Kaye AD, Urits I. (2022). Ketamine-Induced Cystitis: A Comprehensive Review of the Urologic Effects of This Psychoactive Drug. Health Psychology Research, [online] 10(3). https://doi.org/10.52965/001c.38247 .

Charlson F, van Ommeren M, Flaxman A, Cornett J, Whiteford H, Saxena S. (2019). New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. The Lancet, [online] 394(10194), pp.240–248. https://doi.org/10.1016/s0140-6736(19)30934-1 .

Popova V, Daly EJ, Trivedi M, Cooper K, Lane R, Lim P, Mazzucco C, Hough D, Thase ME, Shelton RC, Molero P, Vieta E, Bajbouj M, Manji H, Drevets WC, Singh JB. Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression: a Randomized double-blind active-controlled study. Am J Psychiatry. 2019;176(6):428–38. https://doi.org/10.1176/appi.ajp.2019.19020172 .

doi: 10.1176/appi.ajp.2019.19020172 pubmed: 31109201

Hentzen C, Panicker JN, Pericolini M, Finazzi Agrò E, Chesnel C, Blouet E, Le Breton F, Sheikh Ismaël S, Haddad R, Amarenco G. Persistent need to urinate: a common sensory symptom leading to urinary discomfort. A study of 79 cases. Cont Rep. 2022;2:100007. https://doi.org/10.1016/j.contre.2022.100007 .

doi: 10.1016/j.contre.2022.100007

Yee C-H, Teoh JY-C, Lai P-T, Leung VY-F, Chu WC-W, Lee W, Tam Y-H, Ng C-F. The risk of Upper urinary tract involvement in patients with ketamine-Associated Uropathy. Int Neurourol J. 2017;21(2):128–32. https://doi.org/10.5213/inj.1732704.352 .

doi: 10.5213/inj.1732704.352 pubmed: 28673061 pmcid: 5497195

Zhou J, Scott C, Miab ZR, Lehmann C. Current approaches for the treatment of ketamine-induced cystitis. Neurourol Urodyn. 2023. https://doi.org/10.1002/nau.25148 .

doi: 10.1002/nau.25148 pubmed: 38108523

Lee W-C, Su C-H, Tain Y-L, Tsai C-N, Yu C-C, Chuang Y-C. Potential Orphan Drug Therapy of Intravesical Liposomal Onabotulinumtoxin-A for ketamine-Induced Cystitis by Mucosal Protection and anti-inflammation in a rat model. Sci Rep [online]. 2018;8(1). https://doi.org/10.1038/s41598-018-24239-9 .

Zaki N, Chen L, Lane R, Doherty T, Drevets WC, Morrison RL, Sanacora G, Wilkinson ST, Popova V, Fu D. Long-term safety and maintenance of response with esketamine nasal spray in participants with treatment-resistant depression: interim results of the SUSTAIN-3 study. Neuropsychopharmacology. 2023;48(8):1225–33. https://doi.org/10.1038/s41386-023-01577-5 .

doi: 10.1038/s41386-023-01577-5 pubmed: 37173512 pmcid: 10267177

Wajs E, Aluisio L, Holder R, Daly E, Lane R, Lim P, George JE, Morrison RL, Sanacora G, Young AH, Kasper S, Sulaiman AH, Li CT, Paik JH, Manji HK, Hough D, Grunfeld J, Jeon HJ, Wilkinson ST, Singh J. Esketamine nasal spray plus oral antidepressant in patients with treatment-resistant depression: Assessment of Long-Term Safety in a phase 3, open-label study (SUSTAIN-2). J Clin Psychiatry. 2020;81(3). https://doi.org/10.4088/jcp.19m12891 .

Daly E, Trivedi MH, Janik A, Li H, Zhang Y, Li X, Lane R, Lim P, Duca A, Hough D, Thase ME, Zajecka J, Winokur A, Divacka I, Fagiolini A, Cubała WJ, Bitter I, Blier P, Shelton RC, Singh J. Efficacy of esketamine nasal spray plus oral antidepressant treatment for relapse prevention in patients with treatment-resistant depression. JAMA Psychiatry. 2019;76(9):893. https://doi.org/10.1001/jamapsychiatry.2019.1189 .

doi: 10.1001/jamapsychiatry.2019.1189 pubmed: 31166571 pmcid: 6551577

Spravato 28 mg nasal. spray, solution - Summary of Product Characteristics (SmPC) (emc). www.medicines.org.uk . https://www.medicines.org.uk/emc/product/10977/smpc#gref .

Findeis H, Sauer C, Cleare AJ, Bauer M, Ritter P. Urothelial toxicity of esketamine in the treatment of depression. Psychopharmacology. 2020;237(11):3295–302. https://doi.org/10.1007/s00213-020-05611-y .

doi: 10.1007/s00213-020-05611-y pubmed: 32712681 pmcid: 7561544