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Ketamine Fast Acting, Effective for Suicidal Ideation

63.0 percent of patients reached full remission at day three; remission remained high at 69.5 percent at week six

THURSDAY, Feb. 3, 2022 (HealthDay News) — For patients hospitalized with current suicidal ideation, ketamine is effective and safe in the short term, according to a study published online Feb. 2 in The BMJ.

Mocrane Abbar, M.D., from the University of Montpellier in Nîmes, France, and colleagues conducted a prospective trial between April 13, 2015, and March 12, 2019, involving 156 adults with current suicidal ideation admitted to the hospital voluntarily. Participants were randomly assigned to either placebo or ketamine (83 and 73, respectively), stratified by center and diagnosis.

The researchers found that compared with those receiving placebo, more participants receiving ketamine reached full remission of suicidal ideation at day three (63.0 versus 31.6 percent; odds ratio, 3.7; 95 percent confidence interval, 1.9 to 7.3; P < 0.001). This effect varied by diagnosis (bipolar disorder: odds ratio, 14.1 [95 percent confidence interval, 3.0 to 92.2; P < 0.001]; depressive disorder: odds ratio, 1.3 [95 percent confidence interval, 0.3 to 5.2; P = 0.6]; other disorders: odds ratio, 3.7 [95 percent confidence interval, 0.9 to 17.3; P = 0.07]). Limited side effects were observed and there were no manic or psychotic symptoms. A mediating effect of mental pain was observed. Remission in the ketamine arm remained high at week six, although the difference was not significant versus placebo (69.5 versus 56.3 percent; odds ratio, 0.8; 95 percent confidence interval, 0.3 to 2.5; P = 0.7).

“Whether the emergency use of ketamine for suicidal crises will be recommended in practice depends on many other factors, including the values and preferences of patients, clinicians, researchers, and policymakers,” write the authors of an accompanying editorial.

Several authors disclosed financial ties to the pharmaceutical industry.

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