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Subcutaneous ketamine reduces suicide risk and improves functioning in depression: A proof-of-concept study
Ana Paula Anzolin1, Daniel Prates Baldez2, Bruno Braga Montezano3
1Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Subcutaneous ketamine effectively reduced depressive symptoms and suicidal ideation in patients with severe depression. This NMDA receptor antagonist treatment showed sustained improvements and was well-tolerated, offering a promising therapeutic option.
Area of Science:
- Psychiatry and Pharmacology
- Neuroscience
- Clinical Research
Background:
- Severe depression and suicidal ideation necessitate rapid-onset treatments.
- Current treatments may have limitations in efficacy and speed of action.
- NMDA receptor antagonists represent a novel therapeutic avenue.
Purpose of the Study:
- To evaluate the efficacy of subcutaneous ketamine in reducing depressive symptoms and suicidal ideation.
- To assess the safety and tolerability of this administration route.
- To explore the dose-response relationship and long-term effects.
Main Methods:
- Prospective observational study with 26 patients diagnosed with a depressive episode.
- Subcutaneous ketamine administration initiated at 0.5 mg/kg, with dose adjustments based on response.
- Assessment of depressive symptoms and suicidal ideation using standardized scales (e.g., Columbia Suicide Severity Rating Scale).
Main Results:
- Significant reduction in suicidal ideation and depressive symptoms observed after multiple ketamine sessions.
- Most patients achieved remission within approximately eight sessions.
- A dose-response relationship was identified, with higher doses correlating with greater improvement.
- Sustained benefits and good tolerability with minor, transient side effects were noted.
Conclusions:
- Subcutaneous ketamine is a potentially effective and well-tolerated treatment for severe depression with suicidal ideation.
- This administration route offers a viable, cost-effective alternative, particularly in resource-limited settings.
- Further validation through larger controlled trials is recommended to support broader clinical application.
