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Ketamine reduces suicidal ideation quickly, but may not reduce the short-term likelihood of suicide attempts
Question clinique
In patients at risk of suicide who are admitted to a hospital, does ketamine reduce suicidal ideation?
L’Essentiel
Ketamine can rapidly reduce suicidal ideation and, presumably, the risk of suicide in at-risk patients voluntarily admitted to a hospital. However, based on this small study, ketamine doesn't seem to reduce the subsequent risk of attempted suicide over the next 6 weeks. 1b-
Référence
Plan de l'etude: Randomized controlled trial (double-blinded)
Financement: Government
Cadre: Inpatient (ward only)
Sommaire
These researchers from 7 hospitals in France enrolled 156 adults who were voluntarily admitted for suicidal ideation with a score of greater than 3 on the scale for suicidal ideation. The patients, who did not have a history of substance use or psychotic disorders, were randomly assigned, using concealed allocation, to receive two 40-minute ketamine 0.5 mg/kg or saline placebo infusions, given 24 hours apart. Using intention-to-treat analysis, remission of suicidal ideation at 3 days (1 day after the treatment) occurred more frequently in patients who received ketamine: 63% vs 31.6%; number needed to treat = 3.2; 95% CI 2.2 - 6.6. The onset of remission was fast, within 40 minutes of the first dose. However, over the 6 weeks following admission, a similar number of patients attempted suicide in both groups.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Commentaires
Role ketamine in suicidal tendency
Ketamine a dissociative anaesthetic having an edge effect on suicidal tendency is useful on acute episodes and doesn't have impact on long term tendency of the same impulse
ketamine and suicide risk
One of the most potentially impactful POEMS I have seen! thanks!
ketamine for decreasing suicidal ideation
works in acute admission phase but maybe not after 6 wks