IV Ketamine Offers Rapid Relief from Suicidal Thoughts

If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.

Suicide is a growing public health crisis with limited treatment options. A 2020 survey by the Centers for Disease Control & Prevention revealed more than one in ten respondents said they had “seriously considered” suicide in the past 30 days. For those ages 18 to 24, the number was a shocking 1 in 4.

While talk therapy and antidepressants can be effective in the long-term, suicidality is a crisis that requires immediate attention. Because ketamine can rapidly relieve suicidal thoughts—often within 24 hours—it can provide crucial stabilization for someone in crisis.

Treatment guidelines recommend Prozac (fluoxetine), Celexa (citalopram), and Zoloft (sertraline) as first-line treatments for moderate to severe depression, but they take weeks to work and sometimes yield only modest improvement. Fewer than half of all patients feel any relief at all from typical first-line medications and, while there is an alarming increase in suicidality among young people, some studies show little benefit from first-line medications in adolescents. All first-line antidepressants carry a boxed warning of an actual increased risk of suicide.

Ketamine and suicidality – Research-backed treatment

Scores of studies published in the medical literature have demonstrated the remarkable effects of ketamine in the treatment of suicidal patients. One study in The American Journal of Psychiatry shows a single dose of ketamine rapidly reduced suicidal thoughts, within 24 hours and for up to 1 week in depressed patients. 1 Wilkinson ST, Ballard ED, et al The Effect of a Single Dose of Intravenous Ketamine on Suicidal Ideation: A Systematic Review and Individual Participant Data Meta-Analysis. Am J Psychiatry. 2018 Feb The anti-suicidal effect of ketamine in depressed patients occurs rapidly and significantly in many patients and how long the effect lasts can vary. For many patients, suicidal ideation is a recurrent and persistent struggle. In studies on patients suffering from suicidal ideation, most findings report the effects from a single dose of IV ketamine lasting about one week. The treatment model at Ketamine Wellness Centers uses 4-6 stabilization infusions over a 2-week period, followed by maintenance treatments on an as-needed basis. A study of patients receiving a course of several IV ketamine infusions over several days found: “rapidly and robustly decreased suicidal ideation in patients with treatment-resistant depression. In some patients, this decrease was maintained for at least 3 months following the final ketamine infusion.” 2 lorem ipsum dolar Sustained results are more likely with a comprehensive follow-up support plan in place. Ketamine’s anti-suicidal effect appears to come from its unique ability to work in several different ways at the same time. Research continues to uncover the exact mechanism of ketamine. In the process, this research is helping us make significant new strides towards understanding more about depression and suicidality itself.

Why choose ketamine infusion therapy?

An analysis of 24 articles including clinical trials indicated IV ketamine to be an effective treatment for suicidality. There are several other ways of administrating ketamine (intramuscular, intranasal, and oral) however the data on these alternatives is less conclusive than the results seen from IV ketamine. 3Dadiomov, David, and Kelly Lee. “The effects of ketamine on suicidality across various formulations and study settings.” The mental health clinician vol. 9,1 48-60. 4 Jan. 2019

A 2021 review of 323 published medical studies confirmed “[ketamine’s] clear effectiveness in reducing symptoms of depression and suicidal ideation, either after a single administration, or especially when administered repeatedly.”4 Ketamine Wellness Centers base our protocol from the evidence of multiple studies that have demonstrated that 0.5 mg/kg of ketamine infused over 40 minutes definitively reduced suicidal ideation and depressive symptoms. Clinically controlled infusions with continual monitoring from healthcare professionals are key to the best possible patient care and to the success of the treatment.

Ketamine and suicidality in young people

“Suicide is the second leading cause of death in adolescents. 40% of depressed adolescents don’t respond to lengthy first-line treatments. Another half of those don’t respond to additional medications paired with regular psychotherapy,” says Dr. Ellen Diamond Ph.D., Chief Psychologist with Ketamine Wellness Centers.

“Adolescents and young adults are not psychologically, or physically mature adults and brain development is incomplete. Although the human brain matures in size during adolescence, important developments still take place well into one’s 20s. Typical first-line antidepressants work on the brain’s serotonin and norepinephrine systems which are not fully mature in children and young adults.

Four published studies show ketamine to generally improve depressive symptoms, decrease acute suicidality, and reduce dangerous mood swings in young people.5 In an earlier 2018 study published in the Journal of Child and Adolescent Psychopharmacology researchers from the Mayo Clinic and the University of Minnesota found participants aged 14 to 18 showed an average 42.5% decrease in depression measured on the Children’s Depression Rating Scale (CDRS). Moreover, five of the teens in the study met the criteria for remission.

Dr. Diamond recommends ketamine be used for patients who have not responded to other medications. When infusions are provided in a clinical setting, patients can be carefully monitored, and medications can be adjusted in real-time, which is imperative in young patients. Higher doses of Ketamine have been widely and safely used in children over the past 30 years as an anesthetic thanks to its excellent safety profile.

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Ketamine Wellness Centers working with veterans and first responders

In 2018 (the last year for which data are currently available) the total number of Veteran suicide deaths was tragically 6,435. While the total number of veterans had decreased, the average number of Veteran suicides each day had risen to 17.6.

At Ketamine Wellness Centers we feel a special debt of gratitude to our veterans and first responders. Many on our care teams are themselves veterans and first responders which puts them in a unique position to truly understand many of the challenges involved. To honor this special group of people we have created a unique Heroes’ Program.

There is hope, there is help.

Talk with us to learn more about ketamine and suicidality.

Studies on Ketamine for Suicidality

1. In 2018, a group of researchers analyzed 10 different studies on ketamine infusions for suicidality. Data consistently showed that a single dose of ketamine “rapidly reduced suicidal thoughts” within one day, an effect which lasted for up to one week. This stabilizing effect could create an opportunity to successfully incorporate other therapies (such as CBT and additional medications) in order to maximize treatment outcomes.

2.  A group of individuals suffering from major depressive disorder and suicidal ideation for 3 months or longer were given 6 ketamine infusions over the course of 3 weeks. Researchers observed that ketamine treatment “robustly decreased suicidal ideation.” This remission in suicidal thoughts persisted for up to three months for some patients.

3.  In response to the “devastating public health problem” of suicide, a 2015 study examined the efficacy of ketamine in rapidly reducing suicidal ideation. Researchers found that patients who received a single ketamine infusion reported a significant decrease in suicidal ideation within 48 hours. This study also found ketamine to be more effective than the benzodiazepine midazolam in rapid symptom relief. These findings suggest that ketamine infusion may serve as a crucial intervention for patients in need of rapid relief from suicidal ideation.

4. A double-blind, placebo-controlled study in France noted the value of ketamine for suicidal patients due to its fast-acting nature. Ketamine was found to drastically reduce suicidal ideation for six weeks among patients in this study. In particular, patients diagnosed with bipolar disorder responded well to ketamine treatment.

References

3 Dadiomov, David, and Kelly Lee. “The effects of ketamine on suicidality across various formulations and study settings.” The mental health clinician vol. 9,1 48-60. 4 Jan. 2019

4 Carboni, Ezio et al. “Repurposing Ketamine in Depression and Related Disorders: Can This Enigmatic Drug Achieve Success?.” Frontiers in neuroscience vol. 15 657714. 30 Apr. 2021

5 Kim S, Rush BS, Rice TR. A systematic review of therapeutic ketamine use in children and adolescents with treatment-resistant mood disorders. Eur Child Adolesc Psychiatry. 2020 May 8.