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Intravenous Ketamine in Suicidal Ideation in Depression

Risha Jatal, Abhishek Samarth, Srushti Deulkar

Journal of Medical Excellence 2026 DOI: 10.4103/jome.jome_17_25 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Retrospective case series Case report Peer reviewed
Sample size 4
Population Adults with major depressive disorder and active suicidal ideation
Interventions Intravenous ketamine ongoing antidepressant treatment
Dose 0.5 mg/kg over 40 minutes
Measures Beck Scale for Suicide Ideation, Hamilton Depression Rating Scale
Topics Depression Esketamine Ketamine
Key findings In four adults with major depressive disorder and active suicidal ideation, intravenous ketamine produced rapid reductions in suicidal ideation within hours to days and improvement in depressive symptoms, with only mild, transient adverse effects. The authors propose that intravenous ketamine may be a rapid, well-tolerated option for acute reduction of suicidal ideation, and they call for further controlled studies.

Abstract

A BSTRACT Major depressive disorder is commonly associated with suicidal ideation, while conventional antidepressants have a delayed onset of action. Ketamine has emerged as a rapid-acting antidepressant with potential anti-suicidal effects. This retrospective case series evaluated the effectiveness and tolerability of intravenous ketamine in patients with major depressive disorder and active suicidal ideation. Four adult patients received intravenous ketamine (0.5 mg/kg over 40 minutes) alongside ongoing antidepressant treatment. Suicidal ideation and depressive severity were assessed using the Beck Scale for Suicide Ideation and the Hamilton Depression Rating Scale. All patients showed rapid reduction in suicidal ideation within hours to days, with improvement in depressive symptoms. Adverse effects were mild and transient. Intravenous ketamine appears to be a rapid and well-tolerated option for acute reduction of suicidal ideation, warranting further controlled studies.

Comparable studies

Other case reports and case series on ketamine for depression, most cited first.

Study Year Design Participants
Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
A longitudinal case series of IM ketamine for patients with severe and enduring eating disorders and comorbid treatment‐resistant depression Patients with enduring eating disorders and treatment-resistant depression 2021 Case series n = 4
Effects of intranasal (S)-ketamine on Veterans with co-morbid treatment-resistant depression and PTSD: A retrospective case series Veterans with co-morbid depression and PTSD 2022 Retrospective case series n = 35
Case report: Intramuscular ketamine or intranasal esketamine as a treatment in four patients with major depressive disorder and comorbid anorexia nervosa Patients with anorexia nervosa and a comorbid depressive disorder treated at a private... 2023 Case report n = 4
Repeated oral esketamine in patients with treatment resistant depression and comorbid posttraumatic stress disorder Patients with treatment-resistant depression and comorbid PTSD 2023 Case series n = 5

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