Harnessing the potentials of intravenous ketamine among non-responders of depressive episodes with suicidal ideations and attempts: a case series
Mohammad Shamsul Ahsan, Leuza Mubassara, Ananya Kar, Touhida Ferdousi, Abul Bashar Md Siddique, Shabnam Saba
Bangladesh Journal of Psychiatry October 5, 2026 DOI: 10.3329/bjpsy.v38i1.93752 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 6 |
| Population | Patients aged 24–36 with severe major depressive disorder and suicidal ideation or thoughts; five had treatment-resistant depression and one had severe MDD with suicidal thoughts and non-adherence to treatment |
| Intervention | Ketamine |
| Dose | 0.5 mg/kg diluted with 50 ml distilled water |
| Measures | Modified Scale for Suicidal Ideation (MSSI) |
| Topics | Esketamine Ketamine |
| Key findings | Three of six patients with severe, largely treatment-resistant depression and suicidal ideation responded to acute intravenous ketamine infusion, while three did not. The authors attribute this split to variability in individual responses and argue that treating treatment-resistant depression is complex and requires personalized therapeutic approaches. |
Abstract
Depressive episodes are common but has great impact either in unipolar or bipolar mood disorder. Medical management of severe depression with suicidal attempts are challenging. The rate of Major Depressive Disorder (MDD) who are non-responders are about 30% of those receiving treatment in research settings. Over the past 15 years, ketamine infusions have demonstrated rapid antidepressant and anti-suicidal effects in patients with MDD, with 71% experiencing a 50% or greater reduction in the severity of suicidal ideation on the first day. Despite these promising outcomes, there is limited knowledge about the likelihood of responses to ketamine in real world settings. In this case series, six patients aged 24-36 with severe MDD with suicidal ideations and/ thoughts were treated with intravenous ketamine therapy. Each subject received a subanesthetic dose of 0.5 mg/kg of ketamine diluted with 50ml distilled water administered intravenously over 40 minutes in a micro burette and delayed more when there are side effects if any, under supervision of anesthetist in High Dependency Unit (HDU). A modified scale for suicidal ideation (MSSI) was used for psychometric assessment. Of the six patients, five were treatment resistant depression (TRD) and one with severe MDD with suicidal thoughts and non-adherence to treatment. Three of the six patients responded positively to the acute infusion phase, while three did not, highlighting the variability in individual responses to ketamine therapy. This case series underscores the complexity of treating patients with treatment-resistant depression and emphasizes the need for personalized therapeutic approaches. Bang J Psychiatry 2024;38(1): 19-25
Comparable studies
Other case reports and case series on ketamine, most cited first.