A Pilot Study of Ketamine Infusion after Suicide Attempt: New Frontiers in Treating Acute Suicidality in a Real-World...

Area of Science:

• Psychiatry
• Neuroscience
• Pharmacology

Background:

• Suicidal ideation is a critical public health concern.
• Ketamine has demonstrated rapid antidepressant effects in research settings.
• The efficacy of ketamine for suicidality in real-world, high-risk populations requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of a single intravenous ketamine infusion in reducing suicidal ideation and depression in medically hospitalized patients who recently attempted suicide.
• To assess the durability of ketamine's effects on suicidality over a six-month period.

Main Methods:

• An open-label pilot study involving 16 transdiagnostic Consultation-Liaison (CL) psychiatry patients (aged 18-65) who had recently attempted suicide.
• Patients received a single intravenous ketamine infusion (0.5 mg/kg) in an acute medical setting and were psychiatrically hospitalized post-infusion.
• Suicidality and depression were assessed at baseline and at 24 hours, 5 days, 12 days, 1 month, 3 months, and 6 months post-infusion using paired t-tests.

Main Results:

• A rapid and statistically significant decrease in suicidal thoughts and depression was observed within 24 hours and 5 days post-infusion (p's < 0.001).
• Effect sizes for the reduction in suicidality were large to very large (Cohen's d: 1.7-8.8).
• These improvements in suicidality were consistently maintained up to six months post-infusion.

Conclusions:

• Open-label ketamine infusion demonstrated rapid and robust reduction of suicidal symptoms in a heterogeneous, high-risk patient sample.
• Ketamine infusion appears to be a safe, feasible, and viable method for rapidly reducing suicidality in medically hospitalized patients following a suicide attempt.
• Ketamine may offer enduring benefits and could be integrated into existing healthcare settings as a novel tool for treating suicidality.