Suicide is a major health crisis and ranks the top 3 causes of mortality worldwide for individuals between the ages of 15 and 44. Suicide rates have increased over the last two decades and studies suggest that approximately 90% of patients who commit suicide suffer from a treatable psychiatric disorder, most commonly a mood disorder (depression, anxiety, etc.). Current treatment options for patients who are at risk for suicide are limited and consist of hospitalization, medications, therapy, and electroconvulsive therapy (ECT). These current treatment modalities have been shown to reduce suicide deaths and rate of attempts in the long-term, however they have not been shown to be effective in the acute setting.
Recent studies demonstrate the positive effects that a single dose of IV ketamine has on suicidal thoughts. It has been found that ketamine significantly reduces suicidal thoughts within one day that extended one week post administration. Interestingly, when controlling for improvements in the severity of depressive symptoms, the effect on suicidal thoughts remained significant. This suggests that ketamine’s effect on suicidal thoughts depends only partially on the change in overall severity of depressive symptoms. In this study, approximately 55% of patients were free of suicidal thoughts 24 hours after single dose infusion and 60% were free of suicidal thoughts one week after administration. This is in comparison to ECT which showed 38% of patients free of suicidal thoughts after three treatments in one week. To put things into context ECT is currently considered the standard of care for patients with mood disorders and active suicidal thoughts.
While ketamine may decrease the severity and/or frequency of suicidal ideation or thinking, only hospitals and emergency rooms can properly treat people in emotional distress or experiencing a suicidal crisis.
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