According to a study published in the American Journal of Psychiatry, adjunctive treatment with ketamine was not only significantly more effective in decreasing suicidal thoughts in depressed patients compared to a common sedative, but its effects were seen within hours after administration. 

Clinical studies evaluating antidepressants primarily have not included patients with suicidal thoughts and behavior. Previous studies have shown that low-dose ketamine, an anesthetic, can quickly reduce depressive symptoms and may reduce suicidal thoughts. 

Researchers from Columbia University Medical Center enrolled 80 adults with depression and clinically significant suicidal thoughts; they were randomized to receive low-dose ketamine or midazolam infusions. The primary endpoint was Scale for Suicidal Ideation (SSI) score 24 hours post-infusion.

The ketamine-treated patients demonstrated a clinically significant reduction in suicidal thoughts compared to the midazolam-treated patients within 24 hours (4.96 points greater reduction in SSI, 95% CI: 2.33, 7.59). Moreover, the improvement in suicidal thoughts and depression were maintained for up to 6 weeks in the ketamine-treated group with added optimized standard pharmacotherapy. 

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Study authors also reported that there was a greater improvement in overall mood, depression, and fatigue vs. the midazolam group. Specifically, the impact of ketamine on depression made up 33.6% of its effect on SSI score, leading authors to believe the drug exerted a specific anti-suicidal effect. Dissociation and increased blood pressure were primarily reported as adverse effects but were mild to moderate in nature, resolving within minutes to hours upon receiving ketamine.

Lead author Michael Grunebaum, MD, stated, “This study shows that ketamine offers promise as a rapidly acting treatment for reducing suicidal thoughts in patients with depression. Additional research to evaluate ketamine’s antidepressant and anti-suicidal effects may pave the way for the development of new antidepressant medications that are faster acting and have the potential to help individuals who do not respond to currently available treatments.”

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