Efficacy of single and repeated ketamine administration for suicidal ideation in adults with psychiatric disorders: A meta-analysis.
Progress in neuro-psychopharmacology & biological psychiatry – January 10, 2025
Source: PubMed
Summary
A groundbreaking meta-analysis reveals ketamine's powerful potential in rapidly reducing suicidal thoughts. Analyzing data from nearly 4,000 participants across 49 clinical trials, researchers found that even a single dose significantly decreased suicidal ideation within 4 hours. Peak effectiveness occurred at 24 hours, with benefits lasting up to a month. Multiple doses showed similar success, offering hope for those needing urgent mental health intervention.
Abstract
Previous studies have demonstrated rapid-onset anti-suicidal ideation effects of ketamine. This study aimed to compare the efficacy and duration of anti-suicidal thoughts following single- and repeated-dose ketamine administration. We retrieved published studies on ketamine for suicidal ideation (SI) from PubMed, OVID (MEDLINE), Web of Science, and Embase, spanning from inception to May 1, 2024. Standardized mean differences (SMD) in the SI scores were calculated for continuous outcomes. This study included 49 independent clinical trials involving 3982 participants. After a single ketamine administration, a significant reduction in SI was observed at 4 h (SMD = -0.607, 95 % confidence interval (CI) = [-0.797, -0.418], I2 = 40.69 %), with peak effects observed at 24 h (SMD = -0.955, 95 % CI = [-1.229, -0.682], I2 = 63.66 %) and effects persisted for one month (SMD = -0.948, 95 % CI = [-1.611, -0.285], I2 = 74.32 %). Similar anti-suicidal effects were observed at the treatment endpoint (SMD = -1.228, 95 % CI = [-1.506, -0.950], I2 = 94.56 %) and during a follow-up period of greater than or equal to 1 month (SMD = -1.012, 95 % CI = [-1.695, -0.330], I2 = 80.44 %) with multiple doses of ketamine administration. Single ketamine treatment may have a significant and lasting (up to 1 month) beneficial effect on SI. There was no statistical difference in the efficacy and duration of anti-suicidal thoughts between single and serial ketamine administration.