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Ketamine for suicidality: An umbrella review.

Ahmad Shamabadi1,2, Ali Ahmadzade1, Alireza Hasanzadeh1,2

  • 1School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

British Journal of Clinical Pharmacology
|April 22, 2022
PubMed
Summary

Ketamine shows preliminary short-term efficacy for suicidal ideation and behaviors, but long-term effects are unknown. Most studies were of low quality, necessitating further research into ketamine treatment for suicidality.

Keywords:
ketamineself-injurysuicidal ideationsuicidesystematic review

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Systematic Review Methodology

Background:

  • Suicide is a leading cause of death, highlighting the need for effective treatments.
  • Ketamine has emerged as a potential therapeutic agent for suicidal ideation and behaviors.

Purpose of the Study:

  • To systematically identify and appraise existing systematic reviews on ketamine's efficacy in treating suicidal ideation and behaviors.
  • To synthesize the evidence regarding ketamine's effectiveness and safety profile for suicidality.

Main Methods:

  • A comprehensive search of multiple databases (Scopus, PubMed, Cochrane Library, etc.) was conducted for systematic reviews.
  • Studies were assessed for quality using the AMSTAR-2 tool, and a narrative synthesis was performed.
  • The primary outcome was the inferred effectiveness of ketamine based on the reviewed studies.

Main Results:

  • The majority of reviews suggested preliminary short-term efficacy of ketamine for suicidality.
  • Esketamine demonstrated significant benefits in five out of nine reviews.
  • Common adverse effects included transient increases in pulse and blood pressure, dissociation, and nausea, mostly mild.
  • Over two-thirds of the included studies were of low or critically low quality.

Conclusions:

  • Preliminary evidence supports ketamine's short-term efficacy for suicidal ideation and behaviors.
  • Significant limitations exist due to the low quality of many studies and unknown long-term effects.
  • Further high-quality research is essential to establish ketamine's role in managing suicidality.