Oral ketamine for rapid reduction of suicidal ideation in major depressive disorder: A midazolam-controlled randomized clinical trial.
Asian journal of psychiatry April 1, 2025 Asif Seraj, Mohammed Reyazuddin, R K Gaur et al. 11 citations
A single oral dose of racemic ketamine (3 mg/kg) reduced suicidal ideation and depression symptoms more than an active placebo (oral midazolam, 0.3 mg/kg) in adults with major depressive disorder. Suicidal ideation scores were lower in the ketamine group at 4 hours, day 3, and day 7; depression scores were lower at 4 hours and day 3. By day 7, 25% of ketamine-treated patients responded to treatment (vs. 0% with midazolam), and 5% achieved remission (vs. 0%). Side effects such as nausea, emotional disturbance, and depersonalization were more common with ketamine but not treatment-limiting. Oral racemic ketamine appears reasonably well-tolerated and rapidly effective for suicidal ideation and depression.