Expanding Ketamine Application for Treatment of Acute Suicidality in Long-Duration Spaceflight.
Aerospace medicine and human performance June 1, 2025 Craig J Kutz, Amit M Mistry, Charles H Dukes
Long-duration spaceflight increases the risk of psychiatric emergencies, including acute suicidality, due to factors like isolation, helplessness, and bereavement. Ketamine has emerged as a rapidly effective intervention for acute suicidality on Earth, with advantages including stability, ease of administration, and a favorable safety profile. This literature review of 122 publications, including 23 randomized controlled trials, examined ketamine's potential as a safe, effective pharmacological tool for treating acute suicidal ideation during space exploration missions. The authors argue that as behavioral stressors increase with extended missions, ketamine offers a multifaceted option for behavioral health support, though the review does not aim to revise current International Space Station protocols.