A single dose of intravenous ketamine, added to usual care, reduced suicidal thoughts more than the comparison drug midazolam in adults with major depressive disorder and clinically significant suicidal ideation. Twenty-four hours after infusion, suicidal ideation scores dropped by an average of 4.96 points more with ketamine, and 55% of ketamine-treated patients had at least a 50% reduction in suicidal thoughts compared with 30% of those given midazolam. The benefit was partly independent of improvement in depression and lasted up to six weeks with continued pharmacotherapy. Side effects were short-lived. Ketamine appears to rapidly reduce suicidal ideation in depressed patients, though its mechanism remains unclear.
A randomized clinical trial tested whether Mindfulness-Based Cognitive Therapy to Prevent Suicide (MBCT-S) improves attentional control, an objective marker of suicide attempt, in 135 high suicide risk Veterans. Seventy Veterans received MBCT-S plus enhanced treatment as usual (eTAU), and 65 received eTAU only. Computerized Stroop and emotion Stroop tasks were administered three times over six months. Veterans receiving MBCT-S showed a more favorable trajectory of attentional control over time, with improved combat-stress interference scores. Interference processing time for negative affective words deteriorated over time among Veterans receiving eTAU only. The authors suggest MBCT-S may effectively target attentional control in high suicide risk Veterans.