Ketamine and suicide risk

Abstract

Suicide is a psychiatric emergency, and there are limited pharmacological options to treat acute risk. Recent findings that intravenous ketamine is associated with reductions in suicidal thoughts have fueled interest in ketamine as an antisuicidal agent. The initial data on ketamine and suicide are promising but have not reached the level and rigor of the ketamine and depression literature (which itself is not conclusive). Existing evidence suggests ketamine has a beneficial effect on suicidal thoughts, but additional randomized trials are needed to substantiate this pattern, particularly among samples selected for high suicide risk. Future directions for the field include potential mechanisms or biomarkers of response, clinical correlates, and the relationship of ketamine to suicidal behaviors such as suicide attempts and death by suicide.