Journal article
Ketamine for rapid reduction of suicidal ideation: a randomized controlled trial
Psychological medicine, v 45(16), pp 3571-3580
Dec 2015
PMID: 26266877
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Suicide is a devastating public health problem and very few biological treatments have been found to be effective for quickly reducing the intensity of suicidal ideation (SI). We have previously shown that a single dose of ketamine, a glutamate N-methyl-d-aspartate (NMDA) receptor antagonist, is associated with a rapid reduction in depressive symptom severity and SI in patients with treatment-resistant depression.
We conducted a randomized, controlled trial of ketamine in patients with mood and anxiety spectrum disorders who presented with clinically significant SI (n = 24). Patients received a single infusion of ketamine or midazolam (as an active placebo) in addition to standard of care. SI measured using the Beck Scale for Suicidal Ideation (BSI) 24 h post-treatment represented the primary outcome. Secondary outcomes included the Montgomery-Asberg Depression Rating Scale--Suicidal Ideation (MADRS-SI) score at 24 h and additional measures beyond the 24-h time-point.
The intervention was well tolerated and no dropouts occurred during the primary 7-day assessment period. BSI score was not different between the treatment groups at 24 h (p = 0.32); however, a significant difference emerged at 48 h (p = 0.047). MADRS-SI score was lower in the ketamine group compared to midazolam group at 24 h (p = 0.05). The treatment effect was no longer significant at the end of the 7-day assessment period.
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.
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Details
- Title
- Ketamine for rapid reduction of suicidal ideation: a randomized controlled trial
- Creators
- J W Murrough - Icahn School of Medicine at Mount SinaiL Soleimani - Mood and Anxiety Disorders Program,Department of Psychiatry,Icahn School of Medicine at Mount Sinai,New York,NY,USAK E DeWilde - Icahn School of Medicine at Mount SinaiK A Collins - Icahn School of Medicine at Mount SinaiK A Lapidus - Stony Brook UniversityB M Iacoviello - Icahn School of Medicine at Mount SinaiM Lener - Icahn School of Medicine at Mount SinaiM Kautz - Icahn School of Medicine at Mount SinaiJ Kim - University of California, Los AngelesJ B Stern - Drexel UniversityR B Price - University of PittsburghA M Perez - Icahn School of Medicine at Mount SinaiJ W Brallier - Icahn School of Medicine at Mount SinaiG J Rodriguez - Icahn School of Medicine at Mount SinaiW K Goodman - Icahn School of Medicine at Mount SinaiD V Iosifescu - Icahn School of Medicine at Mount SinaiD S Charney - Icahn School of Medicine at Mount Sinai
- Publication Details
- Psychological medicine, v 45(16), pp 3571-3580
- Publisher
- Cambridge University Press
- Grant note
- K23 MH104465 / NIMH NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Chemical and Biological Engineering
- Web of Science ID
- WOS:000364937200017
- Scopus ID
- 2-s2.0-84945478974
- Other Identifier
- 991019168832604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Psychiatry
- Psychology
- Psychology, Clinical