Ketamine for rapid reduction of suicidal ideation: a randomized controlled trial

Abstract

The current findings provide initial support for the safety and tolerability of ketamine as an intervention for SI in patients who are at elevated risk for suicidal behavior. Larger, well-powered studies are warranted.

Determinants and escitalopram treatment effects on suicidal ideation in patients with acute coronary syndrome: Findings from the K-DEPACS and EsDEPACS studies

“…Second, suicidal ideation was identified using the item "suicidal thoughts" from the MADRS, rather than being defined using a separate or formal instrument. However, this method was used in previous studies in patients with severe physical disorders [24] as well as in patients with depressive disorders [13]. Moreover, a recent study claimed that an item pertaining to suicidal thought taken from a depression rating scale had good validity [33].…”

“…This item assesses the feeling that life is not worth living and the existence of plans for suicide, with scores ranging between 0 (life satisfaction) and 6 (explicit plans for suicide). We considered suicidal thoughts as being present if the patient scored ≥2 (a score of 2 refers to fleeting suicidal thoughts) on this item, as in previous studies [13,24]. The MADRS-ST was evaluated at baseline, in either in-or outpatient settings, and at every follow-up assessment point for the EsDEPACS trial.…”

“…Treatment of depression or anxiety can be considered as treatment of suicidal ideation, as these psychological problems are closely related to suicidal ideation and its modifiable symptoms. In patients with depression or anxiety, several drugs, including escitalopram and ketamine, are reported to be effective in reducing suicidal ideation [11][12][13]. Moreover, several antidepressant trials have reported successful treatment of depression in ACS patients [14][15][16][17]; however, none to date have evaluated suicidal ideation as a treatment outcome.…”

Ketamine: 50 Years of Modulating the Mind

“…Even a single-dose of ketamine may cause rapid antidepressant effects in otherwise treatment-resistant cases of bipolar (DiazGranados et al, 2010b; Ibrahim et al, 2011; Kantrowitz et al, 2015) and major depression (Zarate et al, 2006; Murrough et al, 2013). Remarkably, this also includes the acute reduction of suicidal ideation (DiazGranados et al, 2010a; Larkin and Beautrais, 2011; Zigman and Blier, 2013; Murrough et al, 2015). Recent neuroimaging studies support potential anti-anhedonic and anti-depressant effects, demonstrating its ability to alter glucose metabolism in regions implicated in mood disorders (Lally et al, 2014, 2015; Nugent et al, 2014).…”

Impact of Suicidal Ideation on Long-Term Cardiac Outcomes in Patients with Acute Coronary Syndrome: Sex-Specific Differences

“…SI was identified using the “suicidal thoughts” item of the Montgomery-Asberg Depression Rating Scale (MADRS-ST) [4] the scores of which range between 0 (life satisfaction) and 6 (explicit plans for suicide). Suicidal thoughts were defined as present if the patient scored ≥2 on this item (≥fleeting suicidal thoughts) [5]. The detailed rationale for investigating SI is described in the online supplementary material.…”