Ketamine for Depression and Suicide Risk

This single-arm, open-label trial evaluated intravenous ketamine delivered as an infusion at 0.3 mg/kg/hr over 100 minutes (approximately 0.5 mg/kg per infusion) in hospitalised adults with major depressive disorder or bipolar depression and elevated suicide risk. Acute treatment consisted of thrice-weekly infusions for up to two weeks; participants achieving remission at any acute visit entered a continuation phase of once-weekly infusions for four weeks and then had post-continuation follow-up visits.

Primary efficacy assessments used the Montgomery–Åsberg Depression Rating Scale (MADRS) with remission defined as MADRS total ≤9 24 hours after an infusion; suicidal ideation was monitored clinically and via the MADRS suicide item. Safety assessments included adverse events and standard clinical monitoring during and after infusions.