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Ketamine as a rapid-acting agent for suicidal ideation: A meta-analysis
Francesco Bartoli1, Ilaria Riboldi1, Cristina Crocamo1
1Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.
Neuroscience and Biobehavioral Reviews
|March 27, 2017
Summary
Intravenous ketamine rapidly reduced suicidal ideation in adults. This N-methyl-D-aspartate (NMDA) receptor antagonist showed significant effects within 4 hours, but more research is needed.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Suicidal ideation is a critical public health concern.
- N-methyl-D-aspartate (NMDA) receptor antagonists, such as ketamine, are being investigated for rapid-acting antidepressant effects.
Purpose of the Study:
- To systematically review and meta-analyze the acute effects of intravenous (IV) ketamine on suicidal ideation.
- To assess the efficacy of a single IV ketamine dose within 4 hours of administration.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Inclusion of studies assessing changes in suicidal ideation post-ketamine treatment.
- Random-effects models used to calculate pooled standardized mean differences (SMDs).
Main Results:
- Five studies involving 99 subjects were included.
- A significant and consistent decrease in suicidal ideation was observed (SMD=-0.92).
- Effects were comparable between IV ketamine bolus and infusion, and across different time points.
Conclusions:
- Intravenous ketamine demonstrates a large and consistent acute reduction in suicidal ideation.
- Emerging evidence suggests efficacy, but the quality of current data is considered 'very low'.
- Further high-quality, randomized, controlled, and adequately powered trials are essential to confirm these findings.
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