Results of a small study point to a novel and potentially beneficial effect of the anesthetic medication ketamine. A team of researchers from Massachusetts General Hospital report that repeated low-dose administration of ketamine rapidly reduced suicidal thoughts in patients with treatment-resistant depression. Their report was published Online First in Journal of Clinical Psychiatry. Lead author Dawn Ionescu, MD, of the Depression Clinical and Research Program in the MGH Department of Psychiatry, commented, "Our finding that low doses of ketamine, when added on to current antidepressant medications, quickly decreased suicidal thinking in depressed patients is critically important because we don't have many safe, effective, and easily available treatments for these patients." She added that most previous research into depression alleviation and ketamine excluded patients with currently active suicidal thinking, and many examined only the effect of a single ketamine dose.
Currently-used medications for patients with suicidal ideation include lithium and clozapine, both of which require careful blood monitoring for serious side effects. Electroconvulsive therapy, another option, also entails side effects that include risk of memory loss. Ketamine, a general anesthetic, may also be indicated for treatment of difficult pain syndromes in advanced illness, as has been explored in the Pharmacotherapy track at PAINWeek®. In this study, designed to examine both the safety of repeated ketamine dosage, as well as its antidepressant and antisuicidal efficacy, 14 patients with treatment-resistant depression as well as suicidal thinking received twice-weekly low-dosage ketamine infusions for 3 weeks. Patients were assessed before, during, and for 3 months after the treatment to collect validated measures of suicidal thinking. Most experienced a decrease in their thoughts of suicide, and 7 achieved complete remission of suicidal thoughts. No serious adverse effects were noted at either of 2 dosage levels tested. Dr. Ionescu noted that the study lacked placebo control, and that only the intervenous route of administration was examined.
Read more about the findings here.
The journal abstract may be read here