Sevoflurane augmentation in treatment-resistant depression: a clinical case study

Abstract

Compared with other inhaled anaesthetics, sevoflurane has a faster onset and offset, causes less irritation to the mucous membranes, and has a better safety profile. These characteristics warrant investigating the effect of sevoflurane in depression. In this Case Report, we describe that sevoflurane treatment was feasible and well tolerated by a patient with treatment-resistant depression (TRD). Sevoflurane had rapid and durable antidepressant effects, with few adverse effects. Moreover, the patient showed significant improvements in neurocognitive measurements. Our preliminary results suggest that further clinical trials are needed to determine the independent efficacy and safety of sevoflurane in patients with TRD.

Rapid‐acting antidepressants and the regulation of TrkB neurotrophic signalling—Insights from ketamine, nitrous oxide, seizures and anaesthesia

“…Such reactions are also relatively common with volatile anaesthetics, which could similarly facilitate paradoxical excitation of the cortex during low drug concentrations 42 . To our knowledge, no clinical trials have addressed whether subanaesthetic doses of volatile anaesthetics would possess antidepressant actions, although an interesting recent case report with sevoflurane indicate this 43 . Notably, it may be that there is no optimal dosage that can be generalized to apply to every patient.…”