Ketamine treatment alleviates suicide ideation in high-risk populations: a systematic review and meta-analysis
Wen Tang, Wei-Wei Jiang, Wen-Qian Que, Wan-Qing Zhang, Hong-Lin Chen, Li-Juan Zhou
Epidemiology and Psychiatric Sciences 2026 DOI: 10.1017/s2045796025100371 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Double-blind Open-label Peer reviewed |
|---|---|
| Sample size | 927 |
| Population | High-risk individuals with suicide ideation |
| Intervention | Ketamine |
| Topics | Ketamine Esketamine |
| Keywords | Dosing Suicidal ideation Medline Suicide prevention Systematic review Poison control Meta-analysis Injury prevention |
| Key findings | Ketamine treatment produces a large and clinically meaningful reduction in suicide ideation, especially in younger individuals and those with severe ideation. |
Abstract
Abstract Aims To synthesize the available experimental study evidence to estimate the effects of ketamine on suicide ideation (SI) in high-risk individuals.
Methods: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Double-blind randomized controlled trials and open-label studies investigating the safety and effectiveness of ketamine on SI published up to October 2025 were identified. Data were pooled using random-effects meta-analysis. The main outcome was standardized mean difference on SI in high-risk individuals. Secondary outcomes were the percentage of adverse events and the moderator effects.
Results: We identified 21 studies with a total of 927 participants meeting our inclusion criteria. The pooled effect size for the reduction of SI after ketamine treatment was significant and clinically meaningful (large effect size of −1.40, 95% confidence interval: −2.15 to −0.66, P < 0.001, low–quality evidence). Dissociation (38.8%, P = 0.014), nausea (31.6%, P < 0.001), dizziness (24.7%, P = 0.003), headache (22.0%, P = 0.011) and anxiety (15.8%, P < 0.001) were the frequently reported adverse events. Moderator analyses indicated that the effect was higher in younger individuals and those with severe SI.
Conclusions: Our findings highlight the effectiveness of ketamine in reducing SI in high-risk individuals, especially younger individuals and those with severe ideation. Nonetheless, additional research is required to better understand optimal dosing regimens and the potential long-term effects of ketamine treatment.