A single infusion of ketamine reduces suicidal thoughts in depressed patients in one day, with benefits lasting for up to one week, according to a meta-analysis reported in the American Journal of Psychiatry.
Further, ketamine did not seem to be just treating depression, it seemed to have an effect on suicidal thinking that was greater than its effect on depression
“This suggests that ketamine has a specific effect on suicidal ideation that depends only partly on change in overall severity of depressive symptoms,” Samuel T. Wilkinson, M.D., of the Department of Psychiatry and the Child Study Center at Yale School of Medicine and colleagues wrote.
Wilkinson and colleagues identified 10 previously published controlled studies on ketamine in depression and, by contacting the authors of those studies, they obtained individual subject data on the 298 patients who participated in these ketamine trials; patients in the control arm of the trials received either saline or midazolam, a short acting benzodiazepine used for sedation before medical procedures.
167 of the 298 patients had significant baseline suicidal ideation. Ketamine reduced suicidal ideation more rapidly than was observed with the control treatments on the Montgomery-Åsberg Depression Scale and the Hamilton Depression Scale, as well as on patient self-reports, with significant benefits appearing as early as day 1 after treatment and extending up to day 7.
“The present analysis provides evidence drawn from the largest sample to date that ketamine reduces suicidal ideation partially independently of mood symptoms,” Wilkinson and colleagues wrote. “However, the specificity of this effect requires further exploration. … For ketamine to have a future as a potential anti-suicidal therapeutic in patients with a range of mood and anxiety disorders, studies specifically recruiting diverse populations must be conducted.”
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