Oral ketamine reduces the experience of stress in people with chronic suicidality

In this open-label study (n=32) participants with chronic suicidality received oral ketamine (0.5 mg/kg – 3.0 mg/kg) once per week for a total of 6 weeks with a 4-week follow-up phase to assess the effects of ketamine on their stress. It was found that ketamine significantly reduced stress and in some cases, these effects persisted over the 4-week follow-up showing ketamine’s capacity to alleviate symptoms of stress.

“Background: Stress is prevalent in people experiencing suicidality and is a major contributor to the development of mental disorders. Evidence suggests ketamine shows the capacity to reverse stress-induced brain changes. Though stress and ketamine have been explored individually for suicidality, this study is the first to examine ketamine treatment for self-reported stress in adults with chronic suicidality, building on pre-clinical evidence of ketamine’s capacity to normalize stress-induced responses and contributing to our understanding of oral ketamine in clinical populations.

Methods: Thirty-two adult participants (22-72 years; 17 female) with chronic suicidality completed 6 weeks of active treatment, receiving low (0.5 mg/kg – 3.0 mg/kg) doses of oral ketamine once per week, with a 4-week follow-up phase, to assess the effect of ketamine on their perceived stress. Stress was measured via self-report utilizing the Depression Anxiety Stress Scale-21(DASS-21) and analysed at pre-treatment (week 0), post-treatment (week 6) and at follow-up (week 10).

Results: Repeated measures ANOVA showed a significant reduction in stress (p<.001) post-treatment and Reliable Change Index calculations confirmed this to be clinically significant. Furthermore, those classified as ‘prolonged responders’ demonstrated a sustained reduction in stress at follow-up (i.e. after 4 weeks of nil ketamine).

Limitations: Small sample size, open-label design, expectancy, secondary analysis.

Conclusions: Ketamine showed the capacity to produce a robust and sustained improvement in stress symptoms, in people with chronic suicidality. Future larger, controlled studies examining treatment suitability in a range of stress-related disorders are warranted.

Authors: Megan Dutton, Adem T. Can, Denise Beaudequin, Emma Jensen, Monique Jones, Cyrana C. Gallay, Paul E. Schwenn, Jennifer K. Scherman, Cian Yang, Grace Forsyth, Jim Lagopoulos & Daniel F. Hermens

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