Management of Ketamine Abuse with Dextromethorphan-Bupropion & Naltrexone

Background: Ketamine abuse has been documented as early as the 1970s. Effects of Ketamine intoxication include, but are not limited to, sedation; dream-like states; auditory hallucinations; and visual hallucinations. Long-term abuse has been linked to a variety of pathologies including nephrotoxicity and urinary bladder dysfunction. Despite the degree of harm Ketamine abuse may cause patients, there remains a paucity of literature on how best to manage the condition. Case Presentation: Our case concerns a 20-year male with a history of depression and substance abuse. In the antecedent weeks, the patient had experienced worsening of his depressive symptoms and his Ketamine abuse. The patient was thereafter treated with psychotropic medication, including Dextromethorphan-Bupropion which led to a dramatic improvement in his condition and was thereafter also given Naltrexone therapy to better enhance his abstinence from substance abuse. Conclusion: This article highlights the challenges faced in the management of Ketamine abuse patients, especially in the context of comorbidities such as depression. Here we have highlighted the potential for Dextromethorphan & Bupropion based rapid acting antidepressant therapy along with Naltrexone for the management of patients suffering from this condition.