Ketamine can stop suicidal thoughts finds new study

By Dr. Ananya Mandal, MDDec 18 2017

A study has shown that Ketamine – an anesthetic drug, is capable of reducing and halting suicidal thoughts in depressed patients. The study comes from Columbia University Medical Center (CUMC) who found that it may take only a few hours after administration of ketamine to reduce the suicidal thoughts in the patients.

The study titled, “Ketamine for Rapid Reduction of Suicidal Thoughts in Major Depression: A Midazolam-Controlled Randomized Clinical Trial” was published in the latest issue of the journal American Journal of Psychiatry.

Michael Grunebaum, a research psychiatrist at CUMC and study leader said that there is a “critical window” during which time a suicidal patient requires “rapid relief to prevent self-harm”. He explained that the drugs at hand now are antidepressants that may take weeks to reduce the suicidal thoughts in a patient with depression. He added, “Currently, there is no such treatment for rapid relief of suicidal thoughts in depressed patients.” Further the clinical trials that evaluate the effectiveness of the antidepressants among depressed individuals tend to exclude patients with depressive thoughts and behavior from their studies to obtain their results say researchers. This makes the usefulness of antidepressants and preventers of suicidal thoughts questionable.

There have been previous studies that show that low dose of the anesthetic drug ketamine can cause a rapid reduction in the symptoms of depression and also reduce the suicidal thoughts. For this study the team of researchers included 80 adults with depression who had significant suicidal thoughts. Of these, 54 percent were already taking antidepressants. They were assessed using Scale for Suicidal Ideation (SSI) which yielded a score of over 4 to reveal suicidal thoughts. They received either an infusion of low-dose ketamine or a sedative Midazolam. At 24 hours after the infusion they were again assessed using the SSI to reveal the effects of the respective drugs.

Within 24 hours the group that received ketamine showed a clinically significant reduction in suicidal thoughts when compared to the group receiving midazolam. The scores for ketamine group were 4.96 more than the midazolam group on day 1. Further, 55 percent on the ketamine group responded to this therapy compared to 30 percent in the midazolam group. This improvement in the suicidal thoughts and depression further lasted for up to 6 weeks say the researchers. The participants in the ketamine group reported having better overall mood, reduced depression and fatigue when compared to the midazolam group. One third of its effect was also on reduction of suicidal thoughts which make the researchers call it its “anti-suicidal effect”.

Ketamine use is associated with several side effects including “dissociation” or feeling separated or disjointed from the body. There may also be raised blood pressure during the ketamine infusion. This was however controllable and reduced after the drug administration.

Grunebaum called for additional research to establish the effectiveness of ketamine as an anti-suicidal drug. He added that this could “pave the way for the development of new antidepressant medications that are faster acting and have the potential to help individuals who do not respond to currently available treatments.”