Ketamine for suicidality: An umbrella review
Ahmad Shamabadi, Ali Ahmadzade, Alireza Hasanzadeh
British Journal of Clinical Pharmacology April 22, 2022 DOI: 10.1111/bcp.15360 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review of systematic reviews Peer reviewed |
|---|---|
| Interventions | Ketamine Esketamine |
| Topics | Ketamine Esketamine |
| Keywords | Suicidal ideation Psycinfo Systematic review Medline Cochrane library Cinahl Adverse effect Intensive care medicine Meta-analysis Poison control Emergency medicine Suicide prevention Psychological intervention Electroconvulsive therapy studies |
| Citations | 11 |
| Key findings | Preliminary evidence suggests short-term efficacy of ketamine for suicidal ideation, but long-term effects are unknown and study quality is often low. |
Abstract
The urgent need for appropriate treatment for suicide, the tenth leading cause of death, has led to numerous studies. This study aims to systematically identify and appraise systematic reviews with or without meta-analyses investigating ketamine in suicidal ideation and behaviours. Scopus, ISI, Embase, PubMed, CINAHL, PsycINFO, Cochrane Library, Google Scholar and two registries were searched without any restrictions for systematic reviews investigating the efficacy of ketamine on suicidal ideation and behaviours. The primary outcome was the final inference of ketamine effectiveness. A formal narrative synthesis was conducted, and the AMSTAR-2 tool was used to evaluate the quality of the studies. Of 27 studies that addressed ketamine for suicidal ideation, only four reported mixed or negative results, and out of nine reviews, esketamine was significantly beneficial only in five. A transient rise in pulse rate and blood pressure, dissociation, confusion, blurred vision, nausea and vertigo were the most common adverse effects; however, most were mild. More than two-thirds of the included studies qualified as of low or critically low quality. Preliminary evidence for the short-term efficacy of ketamine in suicidality was noted by the majority of reviews; however, long-term effects remained unknown. Due to the low quality of many studies and the limitations of core studies, further research is required.
Comparable studies
Other systematic reviews and meta-analyses on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis Depressed patients with suicidal ideation at baseline | 2017 | Systematic review and individual participant data meta-analysis | n = 167 |
| Ketamine use: a review Ketamine users | 2011 | Systematic review | |
| Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression Participants with major depression in placebo-controlled, double-blind, randomized... | 2015 | Systematic review and meta-analysis | |
| Ketamine and postoperative pain – a quantitative systematic review of randomised trials Surgical patients from 25 countries | 2004 | Systematic review | n = 2,839 |
| Side-effects associated with ketamine use in depression: a systematic review. Patients with depression | 2018 | Systematic review |
Citations in the library
Cited by 5
- Efficacy and safety of ketamine and esketamine for unipolar and bipolar depression: an overview of systematic reviews with meta-analysis Frontiers in Psychiatry February 1, 2024
- Ketamine Infusions and Rapid Reduction of Suicidal and Depressive Symptoms in Major Depressive Episode: A Systematic Review and Meta-Analysis. JAMA Psychiatry July 1, 2026
- Predictors of responsiveness to ketamine: An updated systematic review of neuroimaging findings. Journal of Affective Disorders July 15, 2026
- Emerging pharmacological and neuromodulation interventions for suicidal ideation and behaviour. European Neuropsychopharmacology July 17, 2026
- Ketamine and esketamine in suicidal thoughts and behaviors: a systematic review Therapeutic Advances in Psychopharmacology 2023
Cites 21
- The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis American Journal of Psychiatry October 3, 2017
- Ketamine for rapid reduction of suicidal thoughts in major depression: a midazolam-controlled randomized clinical trial American Journal of Psychiatry December 5, 2017
- Comparative efficacy of racemic ketamine and esketamine for depression: a systematic review and meta-analysis Journal of Affective Disorders September 23, 2020
- Ketamine for rapid reduction of suicidal ideation: a randomized controlled trial Psychological Medicine August 12, 2015
- The Role of Ketamine in Treatment-Resistant Depression: A Systematic Review Current Neuropharmacology November 12, 2014
and 16 more in the library