Ketamine rapidly reduces suicidal thoughts in people with depression, with effects lasting through the full treatment cycle. A network meta-analysis of 14 studies (1,380 participants) found that within the first day after treatment, suicidal ideation dropped significantly (risk ratio 10.02). Repeated doses produced greater improvement after the last dose than after the first (risk ratio 0.56). By the end of treatment, recovery was significantly better with ketamine than with placebo (risk ratio 4.29 at day 26). This is the first network meta-analysis to demonstrate ketamine's role in alleviating suicidal ideation and to compare drug effects at different time points.
A nomogram prediction model integrating four factors—CRS-R score, brainstem auditory evoked potential (BAEP) grading, N60 classification of somatosensory evoked potentials, and estradiol level—accurately forecasts whether patients with prolonged disorders of consciousness (PDOC) after brain injury will show improved consciousness at six months. In a training cohort of 121 patients, 52.1% improved; in a validation cohort of 49 patients, 51% improved. The model achieved an area under the curve of 0.919 in the training set and 0.888 in the validation set, indicating strong discriminative ability. Calibration and decision curve analyses confirmed the model's accuracy and clinical net benefit.