The July edition of the University of Port Harcourt Teaching Hospital ground rounds featured the
Department of Neuropsychiatrics and Mental Health.
The theme presented was POISONING DEPRESSION: The use of ketamine in the treatment of Major Depressive Disorders(MDD).
A case study of a 35 year old male entrepreneur, who came to the hospital on referral from another medical facility after failed suicidal attempts.
An introduction from the Head of Department Dr. Frances Adukwu, and the lead consultant on patient management, Professor D. Chukwujewu highlighted the challenge with the increasing cases of mental illnesses, citing 2022 World Health Organisation(WHO) report of a record of more than 20 million persons suffering from mental disorders, for which depression and anxiety disorders are most prevalent. Of concern is the fact that Nigeria, in the global ranking is 15th in increasing rate of suicide .
Pre disposing risk factors to MDD were listed to include: stressful life, lack of social support, physical illness etc. Clinical symptoms such as low self esteem, sleep disturbance, impaired concentration, hallucination, negative views and suicidal attempts were seen with the patient presented.
The team upon diagnosing and escalating initial anti-depressant clinical protocol, did not achieve the expected result. The managing team thereafter got requisite consent from patient’s family and employed a multi-disciplinary approach
with the Anesthesia department, to use ketamine, this improved the patient’s appetite, sleep and personal hygiene.
The collaborative management of the patient with the nurses and clinical psychologists led to the discharge of the patient sound and stable after being on admission for 28 days.
Ketamine, an anaesthetic and analgesic agent known for over 50 years as established by the neuropsychiatrics is not in the first line of clinical treatment for MDD as it is in its infant stage of clinical experiment. It’s only advised for clinical use monitored by physicians. They maintain it has a potential in neuropsychiatric therapies.
There are more successes with mental illness in the Department of Neuropsychiatrics and Mental Health, as more persons are encouraged to come access clinical care, against the report of statistics that in a thousand cases of depressive illness only one patient (1000:1) is presented at the clinic for medical intervention.
The hospital ground round was attended by members of staff from various departments, coordinated by Professor O.N. Ekeke and had in attendance the Chairman Medical Advisory Committee, professor Datonye Alasia, and other members of the Hospital Management Committee.