Treatment of Suicidal Ideation in the Emergency Department Using Nitrous Oxide (PROTORISC)

This Phase II interventional trial (n=30), will investigate the efficacy of nitrous oxide in alleviating suicidal ideation (SI).

Suicide prevention is crucial, with thousands of suicides and attempts reported annually in France. While ketamine shows promise in reducing suicidal ideation, its side effects limit its use. Nitrous oxide, another NMDA receptor inhibitor, has demonstrated rapid antidepressant effects with minimal side effects. This trial aims to assess its potential in swiftly alleviating suicidal ideation.

Participants must have active suicidal ideation and be admitted to the psychiatric emergency department. They will receive either inhaled medical air or nitrous oxide for one hour.

The primary outcome measure is the decrease in suicidal ideation severity assessed at hour 4. Secondary measures include assessing depressive symptoms, anxiety intensity, and overall improvement at various time points.

The trial is conducted at University Hospital, Tours, France, and is estimated to start in June 2024 and complete in January 2026.

Trial Details

Suicide prevention is a major public health concern, with nearly 9,000 suicides and over 200,000 suicide attempts reported each year in France. Suicide attempts and suicidal ideation are among the most frequent reasons for emergency room visits and psychiatric hospitalizations. Although there is no approved pharmacological treatment for suicidal crises, some psychiatric treatments appear promising. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has shown promising results in reducing suicidal ideation. However, its use is limited due to its side effects. Nitrous oxide, another NMDA receptor inhibitor commonly used in anesthesia and pain management, has demonstrated rapid antidepressant effects and few side effects. Given its rapid and lasting effects, nitrous oxide could swiftly alleviate suicidal ideation.

NCT Number NCT06430489

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