An Infusion of Ketamine in the Emergency Department Might Reduce Acute Suicidality

Subanesthetic doses of intravenously infused ketamine can reduce depressive symptoms and have been reported to reduce suicidal ideation. To ascertain the strength of these findings, investigators performed a systematic review and meta-analysis of 10 studies that administered a single dose of intravenous ketamine versus saline or midazolam (N=167). Patients had treatment-resistant unipolar or bipolar depression; one study included post-traumatic stress disorder.

The researchers used patient-level data, examined measures targeting suicidal ideation, and controlled for age, sex, treatment setting, diagnosis, concomitant psychiatric medications, and depressive symptoms. Ketamine compared with controls reduced suicidal ideation as early as day 1 …