Ketamine for the acute treatment of severe suicidal ideation: double blind, randomised placebo controlled trial
British medical journal February 2, 2022 M. Abbar, C. Demattei, W. El-Hage et al. 172 citations
Two intravenous infusions of ketamine (0.5 mg/kg) given 24 hours apart, added to usual treatment, led to full remission of suicidal ideas by day 3 in 63.0% of hospitalized patients with suicidal ideation, compared to 31.6% with placebo. The benefit was strongest in patients with bipolar disorder (odds ratio 14.1), not significant in those with depressive disorder (odds ratio 1.3), and intermediate for other disorders (odds ratio 3.7). At six weeks, remission remained high in the ketamine group (69.5% vs 56.3%) but was no longer statistically significant. Side effects were limited, with no manic or psychotic symptoms observed. An analgesic effect on mental pain may explain the anti-suicidal action.