A randomized controlled trial tested a version of mindfulness-based cognitive therapy adapted for suicidal individuals (MBCT-S) combined with treatment as usual against treatment as usual alone. Adults 18 or older with suicidal ideation participated. At a 12-week follow-up, those receiving MBCT-S showed significantly greater reductions in suicidal ideation and depressive symptoms. Within the intervention group, significant decreases occurred in suicidal ideation, depressive symptoms, hopelessness, worrying, defeat, and entrapment, alongside increased mindfulness, both immediately after treatment and at follow-up. The findings suggest MBCT-S is a promising suicide-specific intervention that may reduce suicidal ideation and related factors.
Ketamine's effect on suicidal ideation in adults with treatment-resistant depression remains uncertain. In a phase III double-blind randomized trial comparing subcutaneous racemic ketamine to midazolam over four weeks, one cohort showed no significant difference between groups on either the MADRS item 10 or the C-SSRS measure of suicidal ideation. A second cohort showed a non-significant reduction on the MADRS item 10 but a significant reduction on the C-SSRS. Baseline suicidal ideation scores were low in both cohorts. Adverse events requiring clinical review occurred in 13.8% of all treatment sessions. The authors suggest flexible-dose subcutaneous racemic ketamine may have beneficial effects on suicidal ideation scores, but future studies need to be powered for suicidal ideation as a primary outcome.