Oral ketamine reduces the experience of stress in people with chronic suicidality
Beaudequin, D. A., Can, A. T., Dutton, M., Forsyth, G., Gallay, C. C., Hermens, D. F., Jensen, E., Jones, M., Lagopoulos, J., Scherman, J., Schwenn, P. E., Yang, C.
This open-label study (n=32) investigated the efficacy of weekly oral ketamine (35-210 mg/70 kg) for reducing stress in adults with chronic suicidality. Results indicate that ketamine produced a robust and clinically significant reduction in self-reported stress, which was sustained in a subgroup of participants during the four-week follow-up.
Abstract
Background: Stress is prevalent in people experiencing suicidality and is a major contributor to the development of mental disorders. Evidence suggests ketamine shows the capacity to reverse stress-induced brain changes. Though stress and ketamine have been explored individually for suicidality, this study is the first to examine ketamine treatment for self-reported stress in adults with chronic suicidality, building on pre-clinical evidence of ketamine's capacity to normalize stress-induced responses and contributing to our understanding of oral ketamine in clinical populations. Methods: Thirty-two adult participants (22-72 years; 17 female) with chronic suicidality completed 6 weeks of active treatment, receiving low (0.5 mg/kg - 3.0 mg/kg) doses of oral ketamine once per week, with a 4-week follow-up phase, to assess the effect of ketamine on their perceived stress. Stress was measured via self-report utilizing the Depression Anxiety Stress Scale-21(DASS-21) and analysed at pre-treatment (week 0), post-treatment (week 6) and at follow-up (week 10). Results: Repeated measures ANOVA showed a significant reduction in stress (p<.001) post-treatment and Reliable Change Index calculations confirmed this to be clinically significant. Furthermore, those classified as 'prolonged responders' demonstrated a sustained reduction in stress at follow-up (i.e. after 4 weeks of nil ketamine). Limitations: Small sample size, open-label design, expectancy, secondary analysis. Conclusions: Ketamine showed the capacity to produce a robust and sustained improvement in stress symptoms, in people with chronic suicidality. Future larger, controlled studies examining treatment suitability in a range of stress-related disorders are warranted.