KETAMINE: A POTENTIAL RAPID-ACTING ANTISUICIDAL AGENT?
Samuel T. Wilkinson, Gerard Sanacora
Depression and Anxiety April 15, 2016 DOI: 10.1002/da.22498 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Randomized Open-label Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | Ketamine Esketamine |
| Keywords | Context archaeology Suicidal ideation Randomized controlled trial Clinical trial Placebo Fluoxetine Intensive care medicine Poison control Alternative medicine Surgery Medical emergency |
| Citations | 38 |
| Key findings | Ketamine has a rapid but transient effect in reducing suicidal ideation, though the evidence is very preliminary and further controlled trials are needed. |
Abstract
Ketamine has attracted widespread attention as a potential rapid-acting antidepressant. There is also considerable interest in its use for the rapid treatment of patients deemed at risk for suicide. Here, we review the available evidence (open-label and randomized controlled trials) that examine the effects of ketamine on suicidal ideation (SI). Overall, data suggest that ketamine has a rapid albeit transient effect in reducing SI, though some studies had mixed results at different time points or using different assessments. Weaknesses to the existing literature include the small sample sizes of the studies, the exclusion of patients with significant SI at baseline from many of the studies, and the potential functional unblinding when participants are randomized to saline as placebo. The evidence supporting the clinical use of ketamine for SI is very preliminary. Although ketamine appears to a promising therapeutic option in a context where there is a great unmet need (i.e., patients at imminent risk of suicide), further controlled trials are needed to allow for meaningful clinical recommendations.