Repeated doses of ketamine did not reduce depression or suicidal ideation more than placebo in outpatients with severe, treatment-resistant depression and chronic suicidal thoughts. Twenty-six medicated adults received six infusions of ketamine or saline over three weeks. Neither depression severity nor suicidal ideation differed between groups during the infusion phase. At three months, two patients in each group had remitted from depression. The authors suggest that the standard 0.5 mg/kg dose may be insufficient for this severely ill outpatient population.
An integrative review of 17 studies involving 1,454 surgical patients examined whether mindfulness can reduce pain and anxiety during the perioperative period and whether it is linked to lower opioid use after surgery. Twelve studies focused on postoperative pain: 11 reported that mindfulness decreased pain scores, especially after postoperative day seven. Of seven studies measuring opioid consumption, two found an association between mindfulness and reduced use of opioid pain medications. Five studies focused on preoperative anxiety, and two showed a statistically significant reduction in anxiety with mindfulness. The evidence suggests mindfulness notably reduces postoperative pain beyond one week, but support for reducing opioid use or preoperative anxiety is limited and mixed. More research is needed.