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A Pilot Study of Ketamine Infusion after Suicide Attempt: New Frontiers in Treating Acute Suicidality in a Real-World Medical Setting

Author

Listed:
  • Sharvari Shivanekar

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Priya Gopalan

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Anthony Pizon

    (Department of Emergency Medicine, Division of Medical Toxicology, University of Pittsburgh, 3600 Forbes at Meyran Avenue, Forbes Tower, Suite 10028, Pittsburgh, PA 15213, USA)

  • Crystal Spotts

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Nicolas Cruz

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Michael Lightfoot

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Rebecca Rohac

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Andrew Baumeister

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Angela Griffo

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Benjamin Panny

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Shelly Kucherer

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Alex Israel

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Manivel Rengasamy

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

  • Rebecca Price

    (Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA)

Abstract

Ketamine, in research settings, rapidly reduces suicidal thoughts 2–24 h after a single infusion in patients with high suicidal ideation. In this study, the authors investigate ketamine’s effects on suicidality in a real-world sample of recent suicide attempters on a tertiary-care Consultation-Liaison (CL) psychiatry service. Using an open-label design, 16 transdiagnostic CL patients were recruited, 18–65 years old, to receive a single dose of intravenous ketamine (0.5 mg/kg) in the acute medical setting. All were psychiatrically hospitalized post-infusion. Baseline suicidality and depression measures were compared to ratings taken at 24 h, 5 days, 12 days, and 1, 3 and 6 months post-infusion using paired t-tests. Across all measures, rapid, statistically significant decreases ( p ’s < 0.001) were observed with large to very large effect sizes (Cohen’s d ’s: 1.7–8.8) at acute timepoints (24 h; 5 days). These gains were uniformly maintained to 6 months post-infusion. Open-label ketamine appeared to rapidly and robustly reduced suicidal symptoms in an ultra-high-risk, heterogeneous, real-world sample. Ketamine infusion may therefore be a safe, feasible, viable method to rapidly reduce suicidality among medically hospitalized patients after a suicide attempt, with potentially enduring benefits. The current pilot findings suggest ketamine could be readily integrated into the settings where high-risk CL patients already receive healthcare, with the potential to become an important and novel tool in the treatment of suicidality.

Suggested Citation

  • Sharvari Shivanekar & Priya Gopalan & Anthony Pizon & Crystal Spotts & Nicolas Cruz & Michael Lightfoot & Rebecca Rohac & Andrew Baumeister & Angela Griffo & Benjamin Panny & Shelly Kucherer & Alex Is, 2022. "A Pilot Study of Ketamine Infusion after Suicide Attempt: New Frontiers in Treating Acute Suicidality in a Real-World Medical Setting," IJERPH, MDPI, vol. 19(21), pages 1-15, October.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:13792-:d:951237
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    References listed on IDEAS

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    1. Panos Zanos & Ruin Moaddel & Patrick J. Morris & Polymnia Georgiou & Jonathan Fischell & Greg I. Elmer & Manickavasagom Alkondon & Peixiong Yuan & Heather J. Pribut & Nagendra S. Singh & Katina S. S. , 2016. "NMDAR inhibition-independent antidepressant actions of ketamine metabolites," Nature, Nature, vol. 533(7604), pages 481-486, May.
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