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Suicide Has Many Faces, So Does Ketamine: a Narrative Review on Ketamine’s Antisuicidal Actions

  • Mood Disorders (E Baca-Garcia, Section Editor)
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Abstract

Purpose of Review

Suicidal behaviours are a challenge for a medical system and public health, partly due to the current lack of evidence-based, effective, rapid tools for suicidal crisis management. Ketamine and its enantiomer esketamine have raised hopes regarding this issue in the recent years. However, their efficacy in suicidal behaviours and mechanisms for it remain a topic of debate.

Recent Findings

Subanesthetic ketamine doses rapidly, albeit transiently decrease suicidal ideation, with effects emerging within an hour and persisting up to a week. Current evidence points to various and not necessarily exclusive mechanisms for ketamine’s antisuicidal action, including effects on neuroplasticity, inflammation, reward system and pain processing.

Summary

Ketamine rapidly decreases suicidal ideation, but whether it leads to meaningful clinical outcomes past 1 week is unclear. Multiple putative mechanisms drive ketamine’s antisuicidal action. Future studies will have to show long-term ketamine treatment outcomes and further elucidate its mechanisms of action.

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Authors and Affiliations

  1. Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France

    Aiste Lengvenyte, Emilie Olié & Philippe Courtet

  2. Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania

    Aiste Lengvenyte

  3. Neuropsychiatry, Epidemiological and Clinical Research, INSERM, University of Montpellier, Montpellier, France

    Emilie Olié & Philippe Courtet

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Emilie Olié has received personal fees from Janssen Cilag and Otsuka.

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Lengvenyte, A., Olié, E. & Courtet, P. Suicide Has Many Faces, So Does Ketamine: a Narrative Review on Ketamine’s Antisuicidal Actions. Curr Psychiatry Rep 21, 132 (2019). https://doi.org/10.1007/s11920-019-1108-y

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