Case Study and Case Report 2023; 13(2): 21 - 26.

Noren Q, Omren P. A Case report of the incidental resolution of severe alcohol use disorder During esketamine treatment of major depressive disorder. Case Study and Case Report 2023; 13(2): 21 - 26. ABSTRACT Major depressive disorder (MDD) sufferers are particularly prone to alcohol use disorder (AUD), which is linked to greater rates of morbidity, mortality, disability, and suicide risk. 2019 saw the US FDA approve intranasal esketamine, which has been shown to be a secure and useful therapy choice for MDD that has resisted other therapies. The need for a Risk Evaluation and Mitigation Strategy program for its administration and worries about substance use disorders (SUD) as a potential contraindication or negative effect, however, have limited the availability of esketamine. In this example, a 63-year-old woman with a history of severe MDD that has resisted treatment and a severe alcohol use disorder (AUD) has expressed interest in using esketamine. She started out taking 56 mg of intranasal esketamine twice a week for 20 sessions before moving up to 5 weekly sessions and then 14 weekly sessions of 84 mg. Although PHQ-9 and HAM-D scores decreased and there was an immediate subjective improvement in mood, the dosage was raised to maintain the therapeutic benefit for the duration of the intertreatment period. She managed to get through these sessions without any issues. She also saw a decrease in impulsivity, a decrease in the desire to drink, and a full stop to drinking by the second week. She had one binge relapse while taking 56 mg, which was addressed with motivational therapy, and she hasn't had any alcohol since. This shows that esketamine use is safe and free from the possibility of developing or worsening SUD. Esketamine should not be disregarded as a treatment option for SUD patients because of this, and more study is required to clarify this. Key words: Major, depressive disorder, alcohol, treatment, esketamine