Low dose oral ketamine treatment in chronic suicidality: An open-label pilot study

Summary & key facts

In an open-label pilot study, 32 adults (ages 22–72; 53% female) with ongoing suicidal thoughts took low-dose oral ketamine for six weeks (starting at 0.5 mg/kg and titrated up to 3.0 mg/kg). Average scores on the Beck Scale for Suicide Ideation fell from a high level before treatment to below the clinical threshold after six weeks. By week 6, 69% showed clinical improvement, and 50% still showed significant improvement at the four-week follow-up (week 10). The study was small and not placebo-controlled, so the results are preliminary about feasibility and tolerability rather than conclusive proof of long-term safety or effectiveness.

Key facts:

• The trial enrolled 32 adults with chronic suicidal ideation, aged 22 to 72 years; 53% were female.
• Oral ketamine was given over 6 weeks, starting at 0.5 mg/kg and titrated to a maximum of 3.0 mg/kg.
• The primary outcome measure was the Beck Scale for Suicide Ideation (BSS).
• Mean BSS scores dropped from a high level at baseline (week 0) to below the clinical threshold at the end of treatment (week 6).
• 69% of participants achieved clinical improvement within the first 6 weeks of treatment.
• 50% of participants showed a significant improvement at the 4-week follow-up visit (week 10), after treatment had stopped.
• The study was open-label and had no placebo or control group, which limits how sure we can be about cause and effect.
• The authors noted the pattern of response is consistent with prior intravenous (IV) ketamine studies and suggested oral ketamine may be a feasible and tolerable alternative, but they also said more research is needed on dosing, safety, and

Topics

Electroconvulsive Therapy Studies Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Anesthesia Anxiety Beck Depression Inventory Clinical trial Emergency medicine Injury prevention Internal medicine Ketamine Ketamine hydrochloride Medicine Poison control Psychiatry Suicidal ideation