Ketamine for rapid reduction of suicidal thoughts in major depression: a midazolam-controlled randomized clinical trial
American Journal of Psychiatry December 5, 2017 M. Grunebaum, H. Galfalvy, Tse-Hwei Choo et al. 428 citations
A single dose of intravenous ketamine, added to usual care, reduced suicidal thoughts more than the comparison drug midazolam in adults with major depressive disorder and clinically significant suicidal ideation. Twenty-four hours after infusion, suicidal ideation scores dropped by an average of 4.96 points more with ketamine, and 55% of ketamine-treated patients had at least a 50% reduction in suicidal thoughts compared with 30% of those given midazolam. The benefit was partly independent of improvement in depression and lasted up to six weeks with continued pharmacotherapy. Side effects were short-lived. Ketamine appears to rapidly reduce suicidal ideation in depressed patients, though its mechanism remains unclear.