Ketamine for Suicidality

45 papers and 70 clinical trials exploring ketamine as a treatment for suicidality.

CompoundArylcyclohexylamine

Ketamine

A dissociative anesthetic with rapid-acting antidepressant properties, widely used in clinical settings for mood and pain disorders.

Full Ketamine profile
Indication700,000 deaths annually worldwide.

Suicidality

Suicidality encompasses a spectrum of suicidal thoughts and behaviours, significantly impacting individuals globally. Recent research into psychedelics, particularly ketamine and ayahuasca, shows promise in rapidly alleviating suicidal ideation associated with mental health disorders.

Full Suicidality profile

Academic Research

45 papers
Open Accessindividual

Effect of Esketamine on Depressive Symptoms in Adolescents with Major Depressive Disorder at Imminent Suicide Risk: A Randomized Psychoactive-Controlled Study

This double-blind Phase IIb trial (n=147) evaluated the efficacy, safety, and tolerability of esketamine nasal spray versus midazolam in reducing depressive (MDD) symptoms in adolescents at imminent risk for suicide (SI). The study finds that pooled doses of esketamine (56 and 84 mg) significantly reduce depressive symptoms at 24 hours, with common side effects including dizziness, nausea, and dissociation.

Published
Journal
Journal of the American Academy of Child & Adolescent Psychiatry
Authors
Bloch, M. H., Canuso, C. M., Chen, L. N., DelBello, M., Drevets, W. C., Fu, D. J., Kosik-Gonzalez, C., Lane, R., Moreno, C.
Open Accessindividual

Safety and Efficacy with Esketamine in Treatment-Resistant Depression: Long-Term Extension Study

In the phase 3 SUSTAIN-3 long-term extension (1,148 patients, 3,777 patient‑years), intermittent intranasal esketamine plus an oral antidepressant showed no new safety signals and an adverse event profile consistent with earlier studies. Depression severity improved during induction and was generally maintained during optimisation/maintenance, with remission in 35.6% at induction and about 48–50% at week 112/maintenance endpoint.

Published
Journal
International Journal of Neuropsychopharmacology
Authors
Chen, L. N., Doherty, T., Drevets, W. C., Fu, D. J., Lacerda, A. L. T., Lane, R., Morrison, R. L., Paik, J.-W., Popova, V., Sanacora, G., Wilkinson, S. T., Young, A. H., Zaki, N.
Open Accessindividual

Health Care Resource Use and Medical Costs Among Patients With Major Depressive Disorder and Acute Suicidal Ideation or Behavior Initiated on Esketamine Nasal Spray or Traditional Treatments in the United States

This retrospective cohort study (n=14,912) examines healthcare resource use (HRU) and costs among patients with major depressive disorder (MDD) and acute suicidal ideation or behaviour (SI) initiated on esketamine nasal spray, ECT, SGA augmentation, or antidepressant monotherapy in the U.S. Esketamine-treated patients (n=122) had lower acute care HRU (0.59 days) and costs ($1869/month) compared to ECT (3.17 days, $4624) and SGA augmentation (0.92 days, $2163), but higher than monotherapy (0.32 days, $863). Esketamine reduced HRU (58%) and costs (50%) most significantly from baseline.

Published
Journal
Clinical Therapeutics
Authors
Boonmak, P., Harding, L., Joshi, K., Pilon, D., Shah, A., Teeple, A., Zhdanava, M.
Open Accessindividual

Functional changes in sleep-related arousal after ketamine administration in individuals with treatment-resistant depression

In a randomized, double-blind crossover study of 36 people with treatment-resistant depression (TRD) and 25 healthy volunteers, ketamine altered the temporal dynamics of sleep EEG spectral power in TRD—producing earlier-night increases in delta power and later-night increases in alpha and delta. These spectral changes occurred without effects on sleep macroarchitecture (e.g. WASO, TST, REM latency), did not mediate ketamine’s antidepressant or anti‑suicidal effects, and baseline TRD showed lower total sleep time and shorter REM latency.

Published
Journal
Translational Psychiatry
Authors
Ballard, E. D., Crainiceanu, C. M., Cui, E., Duncan, W. C., Greenstein, D., Hejazi, N. S., Reiss, P. T., Zarate, C. A.
Paywallindividual

Effect of Repeated Intravenous Esketamine on Adolescents With Major Depressive Disorder and Suicidal Ideation: A Randomized Active-Placebo-Controlled Trial

This placebo-controlled trial (n=54) investigates the efficacy and safety of esketamine (iv, 17.5mg, 3x) in adolescents suffering from depression (MDD) and suicidal ideation (SI). It shows significant reductions in Columbia Suicide Severity Rating Scale (C-SSRS) Ideation and Intensity scores and Montgomery-Åsberg Depression Rating Scale (MADRS) scores in the esketamine group compared to the midazolam (placebo) group at day six, with maintained antisuicidal and antidepressant responses at four weeks post-treatment.

Published
Journal
Child and Adolescent Psychiatry
Authors
Chao, Z., Fu, L., Hu, Z., Lan, X-F., Li, W., Liu, H., Ning, Y-P., Wang, C., Ye, Y., Zhang, F., Zhou, Y.

Clinical Trials

70 trials
RecruitingPhase III

A Study to Evaluate the Efficacy and Safety of Esketamine for Reduction of Symptoms of Major Depressive Disorder (AVENUE)

This Phase III, double-blind, randomised, placebo-controlled trial (n=258) will evaluate the efficacy and safety of intranasal esketamine 84 mg in addition to comprehensive standard of care for rapidly reducing symptoms of major depressive disorder (MDD) in adolescent participants aged 12 to 17 with acute suicidal ideation or behaviour. The primary outcome is the change in depressive symptoms measured by the Children's Depression Rating Scale - Revised (CDRS-R) total score at 24 hours post-first dose. Participants will be randomly assigned to receive either intranasal esketamine (84 mg, with potential dose adjustments to 56 mg) plus oral placebo or intranasal placebo plus oral midazolam (0.0625 mg/kg) twice weekly for four weeks. The treatment will occur on specific days, with assessments conducted to monitor the efficacy and safety of the interventions. The trial is sponsored by Janssen Research & Development, LLC, with an estimated start date of January 8, 2026, and a completion date of September 15, 2031.

Started
Type
interventional
Blinding
double
Randomized
Yes
Registry ID
NCT07227454

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