Anti-suicidal effects of IV ketamine in a real-world setting

This community-based study (n=295) examined the impact of intravenous ketamine treatment on suicidality. Using growth mixture modelling, three trajectory groups were identified: one with moderate baseline scores showing gradual improvement (n=170, 57.6%), another with severe baseline scores showing no improvement (n=63, 21%), and a third with rapid improvement (n=62, 21%). Among clinical and demographic variables, only higher scores on active thoughts of death and/or plan predicted a lack of benefit from treatment for those with severe baseline CHRT-SR scores. The findings support ketamine’s potential effectiveness in addressing suicidality in a proportion of patients.

Abstrac of Anti-suicidal effects of IV ketamine in a real-world setting

“The current study evaluated the effectiveness of intravenous ketamine treatment for suicidality in a community-based clinical sample of 295 outpatients (mean age= 40.37; 58.6 % male). We conducted growth mixture modeling to estimate latent classes of changes in symptoms of suicidality measured by the Concise Health Risk Tracking – Self-Report (CHRT-SR) across five infusions in a two-week course of treatment. Best-fit indices indicated three trajectory groups demonstrating non-linear, quadratic changes in CHRT-SR scores during ketamine treatment. The largest group of patients (n= 170, 57.6 %) had moderate CHRT-SR scores at baseline and showed gradual improvement during treatment. The other two groups of patients had severe CHRT-SR scores at baseline and diverged into one group with no improvement throughout treatment (n = 63, 21 %) and one group with rapid improvement (n = 62, 21 %). Of the clinical and demographic variables available and tested, only higher scores pertaining to active thoughts of death and/or plan were found to predict which of the patients with severe CHRT-SR scores at baseline would not benefit from treatment. The present study provides an important contribution to the knowledge of ketamine’s effects on symptoms related to suicide over time. providing support for the possible effectiveness of ketamine in a proportion of patients.”

Authors: Brittany O’Brien, Jaehoon Lee, Seungman Kim, Guriqbal S. Nandra, Prabhneet Pannu, Amanda Tamman, Dania Amarneh, Alan C. Swann, Nicholas Murphy, Lynnette Averill, Manish Jha & Sanjay J. Mathew

Summary of Anti-suicidal effects of IV ketamine in a real-world setting


Suicide is amongst the top three leading causes of mortality in the United States for individuals aged 15 to 44 years and accounts for over 700,000 annual deaths globally. Despite increased efforts to understand its etiology, identify factors moderating risk, and evaluate the effectiveness of available interventions, suicide rates have increased 30% since 2000.

The FDA approved esketamine nasal spray in 2020 for major depressive disorder (MDD) with suicidal thoughts or actions. However, only a few reliable predictors of ketamine treatment response have emerged in preliminary studies, and these findings do not necessarily generalize to suicidal symptoms.

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Anti-suicidal effects of IV ketamine in a real-world setting

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O'Brien, B., Lee, J., Kim, S., Nandra, G. S., Pannu, P., Tamman, A., ... & Mathew, S. J. (2023). Anti-Suicidal Effects of IV Ketamine in A Real-World Setting. Psychiatry Research, 115604.

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295 Humans