ABSTRACT
Ketamine is a noncompetitive N-methyl-D-aspartate antagonist with emerging evidence for use in medically refractory epilepsy. We describe the novel use of low-dose intravenous (IV) ketamine transitioning to enteral formulation in a patient with drug-resistant localization-related refractory epilepsy. We performed a National Library of Medicine (NLM) literature review using search terms "ketamine", "low dose", and "seizure" for similar cases, followed by an illustrative clinical case. Our NLM search engine methodology yielded 24 hits, none of which described use of low-dose ketamine for seizures. Anesthetic doses are used for status epilepticus, but we show that in a patient with postoperative worsening of his chronic seizure burden, low-dose IV ketamine can be used to avoid oversedation and intubation. We demonstrate that IV ketamine can be transitioned to oral regimen to shorten length of stay in the intensive care unit and hospital and has future CYP2B6 pharmacogenomic considerations for further dose individualization.
Subject(s)
Disease Management , Drug Resistant Epilepsy/drug therapy , Excitatory Amino Acid Antagonists/administration & dosage , Ketamine/administration & dosage , Pharmacogenetics/trends , Seizures/drug therapy , Anticonvulsants/administration & dosage , Drug Resistant Epilepsy/genetics , Drug Therapy, Combination , Forecasting , Humans , Male , Seizures/genetics , Young AdultABSTRACT
Increased depression symptomatology results in a reduced willingness to seek help from family. Focusing on Mexican-Americans, the current study hypothesized that the a reduction in favorable perceptions of familial relations could be partially to blame for limited help seeking among people with depression. Data were collected from 84 Mexican-Americans. Measures assessed depression symptomatology, familism, perceptions of help seeking from family, and demographics. As predicted: (1) depression symptomatology was negatively associated with perceptions of help seeking from family; (2) familism was positively associated with perceptions of help seeking from family; and, (3) depression symptomatology was negatively associated with familism. Further, familism partially mediated the relationship between depression symptomatology and help seeking comfort, as well as between depression symptomatology and the perceived utility of familial help seeking. The results indicate a reduction in familistic values may be partially responsible for reduced help seeking among Mexican-Americans with depression.