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dc.contributor.authorIserson, Kenneth V
dc.contributor.authorDurga, Dellon
dc.date.accessioned2020-07-27T21:54:20Z
dc.date.available2020-07-27T21:54:20Z
dc.date.issued2020-05
dc.identifier.citationIserson, K. V., & Durga, D. (2020). Catatonia-Like Syndrome Treated With Low-Dose Ketamine. The Journal of emergency medicine, 58(5), 771–774. https://doi.org/10.1016/j.jemermed.2019.12.030en_US
dc.identifier.issn0736-4679
dc.identifier.pmid32001125
dc.identifier.doi10.1016/j.jemermed.2019.12.030
dc.identifier.urihttp://hdl.handle.net/10150/641950
dc.description.abstractBackground Ketamine's application in psychiatry have expanded, but it appears never to have been previously used to diagnose and treat patients with catatonia-like syndrome that occasionally present to emergency departments. Case Report A 23-year-old male was observed to suddenly stop talking. His ED GCS was 8 and had normal vital signs. While verbally unresponsive, he refused to open his eyes, demonstrated waxy flexibility of his arms, but the balance of his physical, neurological, and laboratory exams were normal. Strongly suspecting a catatonic state, they needed to rapidly confirm that diagnosis or begin evaluating him for potentially life-threatening non-psychiatric illnesses. Lacking other diagnostic modalities, they administered low-dose ketamine boluses. Ketamine 25 mg (1 mL) was diluted in 9 mL NS (2.5 mg/mL). Based on similar protocols, 1 mL of the solution (0.03 mg/Kg) was given intravenously every few minutes. After 12.5 mg ketamine, he was conscious and verbal. Subsequent history confirmed a prior episode requiring an extensive, non-productive medical evaluation. Psychiatry later confirmed the diagnosis. Why Should an Emergency Physician Be Aware of This? Patients with catatonia-like states pose a difficult diagnostic and therapeutic dilemma. Multiple interventions have been used with varying success. Optimal interventions provide a rapid resolution (or demonstrate that a psychiatric cause is not likely), be safe, encompass few contraindications, and be familiar to the clinician. In our patient, subanesthetic doses of ketamine fulfilled these criteria and successfully resolved the condition. If shown effective in other cases, ketamine would be a valuable addition to our psychiatric armamentarium.en_US
dc.language.isoenen_US
dc.publisherELSEVIER SCIENCE INCen_US
dc.rightsCopyright © 2019 Elsevier Inc. All rights reserved.en_US
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/
dc.subjectcatatoniaen_US
dc.subjectdiagnosisen_US
dc.subjectEmergency medicineen_US
dc.subjectKetamineen_US
dc.subjectPsychiatric Disordersen_US
dc.subjectTreatmenten_US
dc.titleCatatonia-Like Syndrome Treated With Low-Dose Ketamineen_US
dc.typeArticleen_US
dc.contributor.departmentUniv Arizona, Dept Emergency Meden_US
dc.identifier.journalJOURNAL OF EMERGENCY MEDICINEen_US
dc.description.note12 month embargo; published online: 27 January 2020en_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal accepted manuscripten_US
dc.source.journaltitleThe Journal of emergency medicine
dc.source.volume58
dc.source.issue5
dc.source.beginpage771
dc.source.endpage774
dc.source.countryUnited States


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