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Ketamine for Treatment of Suicidal Ideation and Reduction of Risk for Suicidal Behavior

  • Complex Medical-Psychiatric Issues (MB Riba, Section Editor)
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Abstract

Ketamine, an NMDA receptor antagonist with efficacy as a rapid anti-depressant, has early evidence for action to reduce suicidal ideation. This review will explore several important questions that arise from these studies. First, how do we measure reductions in suicidal ideation that occur over minutes to hours? Second, are the reductions in suicidal ideation after ketamine treatment solely a result of its rapid anti-depressant effect? Third, is ketamine only effective in reducing suicidal ideation in patients with mood disorders? Fourth, could ketamine’s action lead us to a greater understanding of the neurobiology of suicidal processes? Last, do the reductions in depression and suicidal ideation after ketamine treatment translate into decreased risk for suicidal behavior? Our review concludes that ketamine treatment can be seen as a double-edged sword, clinically to help provide treatment for acutely suicidal patients and experimentally to explore the neurobiological nature of suicidal ideation and suicidal behavior.

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    Faryal Mallick & Cheryl B. McCullumsmith

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Faryal Mallick declares no conflict of interest.

Cheryl B. McCullumsmith served as a consultant and on the advisory board for Janssen for the development of a clinical trial for use of esketamine for the treatment of treatment-resistant depression and acute suicidal ideation.

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Mallick, F., McCullumsmith, C.B. Ketamine for Treatment of Suicidal Ideation and Reduction of Risk for Suicidal Behavior. Curr Psychiatry Rep 18, 61 (2016). https://doi.org/10.1007/s11920-016-0680-7

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