Efficacy of single and repeated ketamine administration for suicidal ideation in adults with psychiatric disorders: A meta-analysis.
Wanting Feng, Chengfeng Chen, Yexian Zeng, Bin Zhang
Progress in neuro-psychopharmacology & biological psychiatry January 10, 2025 DOI: 10.1016/j.pnpbp.2024.111152 via PubMed
Summary
AI-generated from the abstractA meta-analysis of 49 clinical trials with 3,982 participants found that a single dose of ketamine significantly reduces suicidal ideation within 4 hours, with the strongest effect at 24 hours, and benefits lasting up to one month. Repeated doses also produced similar anti-suicidal effects at treatment endpoint and beyond one month. There was no statistical difference in efficacy or duration between single and multiple doses. The analysis suggests that even a single ketamine administration may provide a rapid and lasting reduction in suicidal thoughts.
Study at a glance
| Characteristics | Meta-analysis Peer reviewed |
|---|---|
| Sample size | 3,982 |
| Population | Participants in clinical trials on ketamine for suicidal ideation |
| Intervention | Ketamine |
| Duration | Up to one month follow-up for single dose; follow-up of at least one month for multiple doses |
| Topics | Ketamine |
| Keywords | Meta-analysis Suicidal ideation Ketamine therapy Suicide prevention Mental health treatment |
| Citations | 9 |
| Key finding | Single and repeated doses of ketamine both significantly reduce suicidal ideation, with effects from a single dose appearing within 4 hours and lasting up to one month, and no statistical difference in efficacy between the two regimens. |
Abstract
Previous studies have demonstrated rapid-onset anti-suicidal ideation effects of ketamine. This study aimed to compare the efficacy and duration of anti-suicidal thoughts following single- and repeated-dose ketamine administration. We retrieved published studies on ketamine for suicidal ideation (SI) from PubMed, OVID (MEDLINE), Web of Science, and Embase, spanning from inception to May 1, 2024. Standardized mean differences (SMD) in the SI scores were calculated for continuous outcomes. This study included 49 independent clinical trials involving 3982 participants. After a single ketamine administration, a significant reduction in SI was observed at 4 h (SMD = -0.607, 95 % confidence interval (CI) = [-0.797, -0.418], I2 = 40.69 %), with peak effects observed at 24 h (SMD = -0.955, 95 % CI = [-1.229, -0.682], I2 = 63.66 %) and effects persisted for one month (SMD = -0.948, 95 % CI = [-1.611, -0.285], I2 = 74.32 %). Similar anti-suicidal effects were observed at the treatment endpoint (SMD = -1.228, 95 % CI = [-1.506, -0.950], I2 = 94.56 %) and during a follow-up period of greater than or equal to 1 month (SMD = -1.012, 95 % CI = [-1.695, -0.330], I2 = 80.44 %) with multiple doses of ketamine administration. Single ketamine treatment may have a significant and lasting (up to 1 month) beneficial effect on SI. There was no statistical difference in the efficacy and duration of anti-suicidal thoughts between single and serial ketamine administration.