Ketamine for acute suicidality in the emergency department: A systematic review

Ketamine for suicidality: An umbrella review

“…Other studies have noted similar results with an emphasis on the efficacy of ketamine in emergency situations for SI reduction 19,20,22,23,26,27 . While Wilkinson et al demonstrated 1 week as the effect duration, Maguire et al did not report significant SI improvements any further than 4 hours post‐infusion; however, the studies in the review by Maguire et al were focused only on patients in the emergency department (ED) setting and were conducted using lower ketamine dosages 22,26 .…”

“…Other studies have noted similar results with an emphasis on the efficacy of ketamine in emergency situations for SI reduction 19,20,22,23,26,27 . While Wilkinson et al demonstrated 1 week as the effect duration, Maguire et al did not report significant SI improvements any further than 4 hours post‐infusion; however, the studies in the review by Maguire et al were focused only on patients in the emergency department (ED) setting and were conducted using lower ketamine dosages 22,26 . Interestingly, one of the studies included in several of these reviews was conducted in a background other than TRD or BD, in which a decrease of SI was demonstrated in cancer patients without any past medical history following IV ketamine injection.…”

“…Overall, 15 included reviews were conducted with suicidal ideation as their primary outcome 13–28 . Twelve of the reviews included studies that were carried out in populations of major depressive disorder (MDD) and/or bipolar depression (BD) adults, with or without treatment‐resistant depression (TRD) 13–28 .…”

“…Twelve of the reviews included studies that were carried out in populations of major depressive disorder (MDD) and/or bipolar depression (BD) adults, with or without treatment‐resistant depression (TRD) 13–28 . The eligibility criteria of the other three reviews only required patients to have baseline suicidal ideation 18,19,22 . Given the scarce data on long‐term efficacy, all of these studies only reported acute and emergent properties of ketamine.…”

“…The most notable reported side effects included a transient rise in pulse rate and blood pressure, agitation, confusion, blurred vision, nausea, vomiting, dizziness, drowsiness, vertigo, dysgeusia and transient dissociative symptoms 18,19,22,29 …”