Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Mar;37(3):224-233.
doi: 10.1002/da.22975. Epub 2019 Nov 16.

Ketamine for acute suicidal ideation. An emergency department intervention: A randomized, double-blind, placebo-controlled, proof-of-concept trial

Yoav Domany  1   2   3 , Richard C Shelton  4 , Cheryl B McCullumsmith  5
Affiliations
Randomized Controlled Trial

Ketamine for acute suicidal ideation. An emergency department intervention: A randomized, double-blind, placebo-controlled, proof-of-concept trial

Yoav Domany et al. Depress Anxiety. 2020 Mar.

Abstract

Background: Depressed patients presenting to emergency departments with acute suicidal ideation are a major public health concern. Ketamine, a rapidly acting antidepressant with antisuicidal properties, might offer relief.

Methods: In a randomized, double-blind, placebo-controlled, proof-of-concept trial, 18 depressed subjects with acute suicidal ideation, who required hospitalization, were randomized to either an intravenous ketamine 0.2 mg/kg group or a saline placebo group. Safety and efficacy evaluations were scheduled for 15, 30, 60, 90, 120, 180, and 240 min, and on Days 1, 2, 3, 7, and 14 after infusion. The main outcome measure was suicidal ideation with secondary measures of depression.

Results: Nine subjects were randomized to each group. There were no differences between groups at baseline in any demographic or assessment scales. A reduction in suicidal ideation was noted at 90-180 min (p < .05). Ninety minutes after infusion, 88% of the ketamine group had achieved remission of suicidal ideation compared with 33% in the placebo group (p < .05). No serious adverse events were noted.

Conclusions: Ketamine was safe and effective for rapid reduction in suicidal ideation in depressed, highly suicidal subjects presenting to the emergency department. Our results support further study of ketamine for acute suicidal ideation.

Keywords: acute suicidal ideation; anxiety; depression; hopelessness; ketamine; suicide.

PubMed Disclaimer

References

REFERENCES

    1. aan het Rot, M., Collins, K. A., Murrough, J. W., Perez, A. M., Reich, D. L., Charney, D. S., & Mathew, S. J. (2010). Safety and efficacy of repeated-dose intravenous ketamine for treatment-resistant depression. Biological Psychiatry, 67(2), 139-145. https://doi.org/10.1016/j.biopsych.2009.08.038
    1. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, fourth edition, text revision (DSM-IV-TR). Arlington, VA: Author.
    1. Ballard, E. D., Luckenbaugh, D. A., Richards, E. M., Walls, T. L., Brutsche, N. E., Ameli, R., … Zarate, C. A., Jr. (2015). Assessing measures of suicidal ideation in clinical trials with a rapid-acting antidepressant. Journal of Psychiatric Research, 68, 68-73. https://doi.org/10.1016/j.jpsychires.2015.06.003
    1. Bauer, M. S., Crits-Christoph, P., Ball, W. A., Dewees, E., McAllister, T., Alahi, P., … Whybrow, P. C. (1991). Independent assessment of manic and depressive symptoms by self-rating: Scale characteristics and implications for the study of mania. Archives of General Psychiatry, 48(9), 807-812.
    1. Beck, A. T. (1986). Hopelessness as a predictor of eventual suicide. Annals of the New York Academy of Sciences, 487, 90-96.

Publication types

MeSH terms

LinkOut - more resources