The Effect of Intravenous Ketamine on Suicidal Ideation in Depressed Patients: A Randomized Clinical Trial

Background: Major depressive disorder (MDD) generally occurs together with depression in patients with no history of manic, mixed, or hypomanic episodes. The suicidal ideation in MDD patients is very common and can potentially be considered an emergency circumstance in many cases. Among the developed drugs and medicines, ketamine (KET) is a potential option to treat patients with MDD. This study aims at investigating the effect of KET on the treatment of suicidal ideation and the reduction of the intensity of symptoms in patients suffering from MDD.Materials and Methods: This randomized double-blind clinical trial was performed on ۳۰ patients who suffered from MDD and had suicidal ideation at Ibn Sina Hospital, Bandar Abbas, Iran, during ۲۰۱۶-۲۰۱۷. The patients were divided into two groups: the KET group which received ۰.۵ mg/kg of intravenous (IV) KET diluted in ۵۰۰ mL of normal saline over ۳۰ minutes and the control group which received ۵۰۰ mL of normal saline without KET over ۳۰ minutes.Results: According to the statistical analysis, ۲۴ hours after the intervention, suicidal ideation score reached ۲.۵۳ and ۲۰.۶ in the KET and control groups, respectively. In fact, KET caused a significant reduction in the score of the suicidal ideation (SSI) (SSI<۴) in comparison with the control group (P<۰.۰۰۱).Conclusion: It was observed that KET can play a key role in the treatment of depression disorders, especially severe and life-threatening forms that require immediate intervention, such as the use of electroconvulsive therapy.