Initiating Ketamine in Acutely Suicidal Patients in the Emergency Department
Randomised, parallel, placebo-controlled Phase III ED trial (n=62) testing a single IV ketamine infusion (0.5 mg/kg over 40 minutes) versus saline to reduce suicidal ideation in acutely suicidal military-affiliated adults.
Details
Randomised, quadruple-masked, parallel-group trial in adults presenting to the emergency department with active suicidal ideation comparing a single 0.5 mg/kg IV ketamine infusion (100 ml NS over 40 minutes) versus 100 ml saline.
Primary outcome measures include the Beck Scale for Suicidal Ideation (BSSI) and MADRS-S assessed at baseline, 4 hours, 24 hours and one week post-infusion; secondary analyses include length of stay and safety/tolerability.
Rationale: ketamine’s rapid NMDA-antagonist effects may reduce suicidal ideation via increased synaptic plasticity and modulation of monoaminergic and glutamatergic systems.