NMDA receptor antagonist use in a patient with treatment-resistant depression and comorbid PTSD
30 Apr 2024
byDr. Raymond Ka-Yau Wong
Specialist in Psychiatry
Private practice, Hong Kong
This is the case of a young female professional who was sexually assaulted by her older brother when she was in primary school. The patient had not developed diagnosable psychiatric disorders until April 2023, when exposure of the childhood traumatic event triggered moderate depression (Beck Depression Inventory [BDI] score, 20) and mild anxiety (Beck Anxiety Inventory [BAI] score, 12) as well as severe post-traumatic stress disorder (PTSD) with full-blown symptoms, including flashbacks, insomnia and nightmares every night, anhedonia, dissociation (2–3 times weekly) and conversion symptoms (paralysis) on her right hand and left leg. She withdrew not only from the perpetrator, but also from other family members. She had crying spells, separation anxiety with friends, and decreased work performance due to slow psychomotor speed and poor concentration.
