Takeaway
- This meta-analysis shows evidence of effects in favour of a single infusion of ketamine (0.5 mg/kg) for suicidal ideation in adults with psychiatric disorders.
- These effects were apparent up to 72 hours post-infusion.
- However, future trials are needed to confirm these results.
Why this matters
- Findings suggest that ketamine may have a role in acute treatment for suicidality.
Study design
- 15 independent randomised controlled trials including 572 participants met eligibility criteria after a search on CENTRAL, EMBASE, Medline and PsycINFO.
- Funding: None.
Key results
- In the majority of trials, ketamine (0.5 mg/kg) was administered via an infusion over a 30- to 45-minute period, while only a single trial of esketamine used intranasal route of administration.
- Ketamine infusion (within 4 hours) was associated with a significant reduction in suicidal ideation scores (standardised mean difference [SMD], −0.51; 95% CI, −1.00 to −0.03; I2=73.0%).
- The effect lasted until 72 hours post-infusion (time points >12 but ≤24 hours: SMD, −0.63; 95% CI, −0.99 to −0.26]; between 24 and 72 hours: SMD, −0.57, 95% CI, −0.99 to −0.14).
- After 72 hours, treatment with ketamine was no longer associated with a significant effect for suicidal ideation.
- In a single trial of esketamine, marginal effects on suicidal ideation were noted.
Limitations
- Heterogeneity among included studies.
References
References
