A novel sequential ketamine and D-cycloserine/lurasidone therapy for bipolar depression with acute suicidal ideation.
Expert Opin Investig Drugs May 26, 2026
A review of a two-step approach for bipolar depression with acute suicidal ideation and behavior: an initial intravenous ketamine protocol for rapid symptom relief, followed by maintenance with D-cycloserine and lurasidone to prolong therapeutic effects. The strategy is mechanistically informed but uncertainties remain about which components drive efficacy, optimal dosing, and duration of benefits. Further studies are needed to refine maintenance strategies and translate insights into clinical practice.