Anti-suicidal effects of IV ketamine in a real-world setting
This community-based study (n=295) examined the impact of intravenous ketamine treatment on suicidality. Using growth mixture modelling, three trajectory groups were identified: one with moderate baseline scores showing gradual improvement (n=170, 57.6%), another with severe baseline scores showing no improvement (n=63, 21%), and a third with rapid improvement (n=62, 21%). Among clinical and demographic variables, only higher scores on active thoughts of death and/or plan predicted a lack of benefit from treatment for those with severe baseline CHRT-SR scores. The findings support ketamine's potential effectiveness in addressing suicidality in a proportion of patients.
Authors
- Sanjay Mathew
- Lauren Averill
- Manohar Jha
Published
Abstract
The current study evaluated the effectiveness of intravenous ketamine treatment for suicidality in a community-based clinical sample of 295 outpatients (mean age= 40.37; 58.6 % male). We conducted growth mixture modeling to estimate latent classes of changes in symptoms of suicidality measured by the Concise Health Risk Tracking - Self-Report (CHRT-SR) across five infusions in a two-week course of treatment. Best-fit indices indicated three trajectory groups demonstrating non-linear, quadratic changes in CHRT-SR scores during ketamine treatment. The largest group of patients (n= 170, 57.6 %) had moderate CHRT-SR scores at baseline and showed gradual improvement during treatment. The other two groups of patients had severe CHRT-SR scores at baseline and diverged into one group with no improvement throughout treatment (n = 63, 21 %) and one group with rapid improvement (n = 62, 21 %). Of the clinical and demographic variables available and tested, only higher scores pertaining to active thoughts of death and/or plan were found to predict which of the patients with severe CHRT-SR scores at baseline would not benefit from treatment. The present study provides an important contribution to the knowledge of ketamine's effects on symptoms related to suicide over time. providing support for the possible effectiveness of ketamine in a proportion of patients.
Research Summary of 'Anti-suicidal effects of IV ketamine in a real-world setting'
Introduction
Suicide remains a major public health problem with rapid-onset crises and high lethality on first attempt, and there is a pressing need for interventions that act quickly and have sustained effects. Although the FDA approved esketamine nasal spray for major depressive disorder with suicidal thoughts or actions, the racemic ketamine formulation is widely used off-label and has demonstrated rapid antidepressant effects in controlled trials; meta-analyses, however, report heterogeneous effects on suicidal ideation and a substantial non-responder fraction. Identifying markers of who benefits from ketamine is therefore important, especially given the time and cost burdens of off-label treatment. O'brien and colleagues aimed to examine ketamine's anti‑suicidal effectiveness in a real-world, community clinical sample rather than a tightly controlled trial population. Using a hypothesis-free, data-driven latent-class approach, they sought to (i) identify distinct trajectories of change in suicidality during a short course of intravenous (IV) ketamine and (ii) test whether demographic or clinical variables, including domains of suicidality (propensity, impulsivity and active ideation), childhood maltreatment and depressive symptom severity, distinguished those trajectories.
Expert Research Summaries
Go Pro to access AI-powered section-by-section summaries, editorial takes, and the full research toolkit.
Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- Authors
- APA Citation
O'Brien, B., Lee, J., Kim, S., Nandra, G. S., Pannu, P., Tamman, A., Amarneh, D., Swann, A. C., Murphy, N., Averill, L., Jha, M., & Mathew, S. J. (2024). Anti-suicidal effects of IV ketamine in a real-world setting. Psychiatry Research, 331, 115604. https://doi.org/10.1016/j.psychres.2023.115604
References (7)
Papers cited by this study that are also in Blossom
Kishimoto, T., Chawla, J. M., Hagi, K. et al. · Psychological Medicine (2016)
Meshkat, S., Rodrigues, N. B., Vincenzo, J. D. D. et al. · Journal of Psychiatric Research (2022)
O'Brien, B., Lee, J., Kim, S. et al. · Journal of Affective Disorders (2023)
O'Brien, B., Lijffijt, M., Lee, J. et al. · Journal of Affective Disorders (2021)
Price, R., Kissel, N., Baumeister, A. et al. · Molecular Psychiatry (2022)
Rong, C., Park, C., Rosenblat, J. D. et al. · International Journal of Environmental Research and Public Health (2018)
Wilkinson, S. T., Ballard, E. D., Bloch, M. H. et al. · American Journal of Psychiatry (2017)
Your Personal Research Library
Go Pro to save papers, add notes, rate studies, and organize your research into custom shelves.