This open-label pilot study (n=30) aims to examine the effect of intravenous (IV) ketamine treatment on acute suicidality (SI) in patients with bipolar depression (BD).
This open-label pilot examines IV ketamine given as 40-minute sub-anesthetic infusions twice weekly for four weeks in people with bipolar depression and current suicidal ideation to evaluate acute anti‑suicidal effects.
Neurophysiological mechanisms are assessed using TMS‑EMG and TMS‑EEG to index cortical excitation and inhibition as proxies of NMDA‑receptor mediated activity and to explore predictors of clinical response.
Safety and tolerability are monitored with vital signs, liver function tests, adverse event reporting and clinical assessments; dosing is weight‑based (0.5 mg/kg starting dose, up to 0.8 mg/kg) with close medical supervision.
Open-label series of IV ketamine infusions (twice weekly for 4 weeks) with neurophysiological assessment.
Initial dose 0.5 mg/kg; may be increased up to 0.8 mg/kg per clinician decision; 40-min infusion; 2-h monitoring per session.