Efficacy of single and repeated ketamine administration for suicidal ideation in adults with psychiatric disorders: A meta-analysis.
Wanting Feng, Chengfeng Chen, Yexian Zeng, Bin Zhang
Progress in Neuro-Psychopharmacology and Biological Psychiatry January 10, 2025 DOI: 10.1016/j.pnpbp.2024.111152 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis Peer reviewed |
|---|---|
| Sample size | 3,982 |
| Population | Participants in clinical trials on ketamine for suicidal ideation |
| Intervention | Ketamine |
| Duration | Up to one month follow-up for single dose; follow-up of at least one month for multiple doses |
| Topics | Ketamine Esketamine |
| Keywords | Meta-analysis Suicidal ideation Ketamine therapy Suicide prevention Mental health treatment Clinical research |
| Citations | 9 |
| Key findings | Single and repeated doses of ketamine both significantly reduce suicidal ideation, with effects from a single dose appearing within 4 hours and lasting up to one month, and no statistical difference in efficacy between the two regimens. |
Abstract
Previous studies have demonstrated rapid-onset anti-suicidal ideation effects of ketamine. This study aimed to compare the efficacy and duration of anti-suicidal thoughts following single- and repeated-dose ketamine administration. We retrieved published studies on ketamine for suicidal ideation (SI) from PubMed, OVID (MEDLINE), Web of Science, and Embase, spanning from inception to May 1, 2024. Standardized mean differences (SMD) in the SI scores were calculated for continuous outcomes. This study included 49 independent clinical trials involving 3982 participants. After a single ketamine administration, a significant reduction in SI was observed at 4 h (SMD = -0.607, 95 % confidence interval (CI) = [-0.797, -0.418], I2 = 40.69 %), with peak effects observed at 24 h (SMD = -0.955, 95 % CI = [-1.229, -0.682], I2 = 63.66 %) and effects persisted for one month (SMD = -0.948, 95 % CI = [-1.611, -0.285], I2 = 74.32 %). Similar anti-suicidal effects were observed at the treatment endpoint (SMD = -1.228, 95 % CI = [-1.506, -0.950], I2 = 94.56 %) and during a follow-up period of greater than or equal to 1 month (SMD = -1.012, 95 % CI = [-1.695, -0.330], I2 = 80.44 %) with multiple doses of ketamine administration. Single ketamine treatment may have a significant and lasting (up to 1 month) beneficial effect on SI. There was no statistical difference in the efficacy and duration of anti-suicidal thoughts between single and serial ketamine administration.
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 6
- Anti-Suicidal Effects of Lithium, Ketamine, and Clozapine-A 10-Year Systematic Review. Pharmaceuticals May 18, 2025
- Can ketamine therapy overcome treatment-resistant depression in Alzheimer's disease and older adults? Preclinical and clinical evidence. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie July 1, 2025
- Interdisciplinary, Delphi-driven consensus guidelines on the use of intravenous ketamine infusions for depressive disorders from the American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3). Journal of Affective Disorders May 16, 2026
- Early suicidal ideation change and suicidality-associated emergency department utilization after ketamine or esketamine treatment in treatment-resistant depression. Therapeutic Advances in Psychopharmacology May 22, 2026
- Changes in depression symptom network structure following ketamine treatment in treatment-resistant depression. Journal of Affective Disorders May 14, 2026
and 1 more in the library
Cites 29
- 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
- Efficacy and Safety of Fixed-Dose Esketamine Nasal Spray Combined With a New Oral Antidepressant in Treatment-Resistant Depression: Results of a Randomized, Double-Blind, Active-Controlled Study (TRANSFORM-1) The International Journal of Neuropsychopharmacology July 9, 2019
- Rapid Resolution of Suicidal Ideation After a Single Infusion of anN-Methyl-D-Aspartate Antagonist in Patients With Treatment-Resistant Major Depressive Disorder The Journal of Clinical Psychiatry July 13, 2010
- Ketamine for rapid reduction of suicidal thoughts in major depression: a midazolam-controlled randomized clinical trial American Journal of Psychiatry December 5, 2017
- EFFECTS OF KETAMINE ON EXPLICIT AND IMPLICIT SUICIDAL COGNITION: A RANDOMIZED CONTROLLED TRIAL IN TREATMENT-RESISTANT DEPRESSION Depression and Anxiety March 25, 2014
and 24 more in the library