Ketamine for acute suicidal ideation. An emergency department intervention: A randomized, double‐blind, placebo‐controlled, proof‐of‐concept trial
Open accessAbstract
BACKGROUND: Depressed patients presenting to emergency departments with acute suicidal ideation are a major public health concern. Ketamine, a rapidly acting antidepressant with antisuicidal properties, might offer relief. METHODS: In a randomized, double-blind, placebo-controlled, proof-of-concept trial, 18 depressed subjects with acute suicidal ideation, who required hospitalization, were randomized to either an intravenous ketamine 0.2 mg/kg group or a saline placebo group. Safety and efficacy evaluations were scheduled for 15, 30, 60, 90, 120, 180, and 240 min, and on Days 1, 2, 3, 7, and 14 after infusion. The main outcome measure was suicidal ideation with secondary measures of depression. RESULTS: Nine subjects were randomized to each group. There were no differences between groups at baseline in any demographic or assessment scales. A reduction in suicidal ideation was noted at 90-180 min (p < .05). Ninety minutes after infusion, 88% of the ketamine group had achieved remission of suicidal ideation compared with 33% in the placebo group (p < .05). No serious adverse events were noted. CONCLUSIONS: Ketamine was safe and effective for rapid reduction in suicidal ideation in depressed, highly suicidal subjects presenting to the emergency department. Our results support further study of ketamine for acute suicidal ideation.
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Ketamine reduced suicidal ideation within 1-4 hours in major depression.
“Ketamine, an NMDA glutamate receptor antagonist, reduced suicidal ideation within 1–4 hours in major depression(71–75) and bipolar disorder.(76, 77)”
From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [74]
The Suicidal ideation results (section 3.2; page unavailable) report that ketamine alleviated suicidal ideation 90–180 minutes after infusion, within the claimed 1–4-hour window. But the Participants section (2.1; page unavailable) includes major depression alongside bipolar depression, depression NOS, and dysthymia; the reported effect is for the combined group, not specifically for patients with major depression. (LLM, conf=0.83)
Experimental — accuracy not yet measuredMultiple studies have found high rates of remission of suicidal ideation after a single ketamine infusion in patients hospitalized for acute suicidal ideation.
“Previous research echoes these results, with multiple studies finding high rates of remission for suicidal ideation after a single ketamine infusion in patients hospitalized for acute suicidal ideation [77][78][79].”
From Ketamine in neuropsychiatric disorders: an update (2024) · cites this paper as [77]
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1 retracted
Larkin, G. L., & Beautrais, A. L. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145711000629 · Cited by 254 · see citing works
RetractedHarris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2008.08.010 · Cited by 51,384 · see citing works
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139 · see citing works
An inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407 · see citing works
A new depression scale designed to be sensitive to change
Montgomery, S. A., & Åsberg, M. (1979) · British Journal of Psychiatry · doi:10.1192/bjp.134.4.382 · Cited by 13,962 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069 · see citing works
Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., Niederehe, G., Thase, M. E., Lavori, P. W., Lebowitz, B. D., et al. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.11.1905 · Cited by 5,643 · cited 1× · see citing works
“…is a time lag of weeks to months until full efficacy (Nakajima, Suzuki, Watanabe, Kashima, & Uchida, 2010), Third, about one‐third of patients fail to achieve remission even with advanced treatment strategies (Rush et al., 2006), thus, leaving those suffering acute suicidal ideation at high risk.”
BackgroundThe measurement of pessimism: the hopelessness scale
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974) · Journal of Consulting and Clinical Psychology · doi:10.1037/h0037562 · Cited by 5,494 · see citing works
Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., et al. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.10111704 · Cited by 5,157 · cited 2× · see citing works
“Baseline suicidal ideation, the intensity of ideation, and behaviors were assessed using the C‐SSRS (baseline and versions; Posner et al., 2011).”
MethodAntidepressant effects of ketamine in depressed patients
Berman, R. M., Cappiello, A., Anand, A., Oren, D. A., Heninger, G. R., Charney, D. S., & Krystal, J. H. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00230-9 · Cited by 3,856 · see citing works
A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression.
Zarate, C. A., Singh, J. B., Carlson, P. J., Brutsche, N. E., Ameli, R., Luckenbaugh, D. A., Charney, D. S., & Manji, H. K. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.8.856 · Cited by 3,766 · see citing works
Julian, L. J. (2011) · Arthritis Care & Research · doi:10.1002/acr.20561 · Cited by 1,794 · see citing works
The NIMH Research Domain Criteria (RDoC) Project: Precision Medicine for Psychiatry
Insel, T. R. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2014.14020138 · Cited by 1,472 · see citing works
Murrough, J. W., Iosifescu, D. V., Chang, L. C., Al Jurdi, R. K., Green, C. E., Perez, A. M., Iqbal, S., Pillemer, S., Foulkes, A., Shah, A., et al. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13030392 · Cited by 1,205 · see citing works
Bremner, J. D., Krystal, J. H., Putnam, F. W., Southwick, S. M., Marmar, C., Charney, D. S., & Mazure, C. M. (1998) · Journal of Traumatic Stress · doi:10.1023/a:1024465317902 · Cited by 817 · see citing works
Wilkinson, S. T., Ballard, E. D., Bloch, M. H., Mathew, S. J., Murrough, J. W., Feder, A., Sos, P., Wang, G., Zarate, C. A., & Sanacora, G. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.17040472 · Cited by 696 · see citing works
Safety and Efficacy of Repeated-Dose Intravenous Ketamine for Treatment-Resistant Depression
aan het Rot, M., Collins, K. A., Murrough, J. W., Perez, A. M., Reich, D. L., Charney, D. S., & Mathew, S. J. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.08.038 · Cited by 690 · see citing works
Canuso, C. M., Singh, J. B., Fedgchin, M., Alphs, L., Lane, R., Lim, P., Pinter, C., Hough, D., Sanacora, G., Manji, H., et al. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.17060720 · Cited by 676 · see citing works
Wilkinson, P., Kelvin, R., Roberts, C., Dubicka, B., & Goodyer, I. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10050718 · Cited by 645 · see citing works
Price, R. B., Nock, M. K., Charney, D. S., & Mathew, S. J. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.04.029 · Cited by 600 · see citing works
DiazGranados, N., Ibrahim, L. A., Brutsche, N. E., Ameli, R., Henter, I. D., Luckenbaugh, D. A., Machado-Vieira, R., & Zarate, C. A. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05327blu · Cited by 564 · see citing works
Singh, J. B., Fedgchin, M., Daly, E. J., De Boer, P., Cooper, K., Lim, P., Pinter, C., Murrough, J. W., Sanacora, G., Shelton, R. C., et al. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.16010037 · Cited by 525 · see citing works
Self-citationFava, M., Freeman, M. P., Flynn, M., Judge, H., Hoeppner, B. B., Cusin, C., Ionescu, D. F., Mathew, S. J., Chang, L. C., Iosifescu, D. V., et al. (2020) · Molecular Psychiatry · doi:10.1038/s41380-018-0256-5 · Cited by 433 · see citing works
Grunebaum, M. F., Galfalvy, H. C., Choo, T.-H., Keilp, J. G., Moitra, V. K., Parris, M. S., Marver, J. E., Burke, A. K., Milak, M. S., Sublette, M. E., et al. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.17060647 · Cited by 431 · see citing works
Independent Assessment of Manic and Depressive Symptoms by Self-rating
Bauer, M. S. (1991) · Archives of General Psychiatry · doi:10.1001/archpsyc.1991.01810330031005 · Cited by 408 · see citing works
Price, R. B., Iosifescu, D. V., Murrough, J. W., Chang, L. C., Al Jurdi, R. K., Iqbal, S. Z., Soleimani, L., Charney, D. S., Foulkes, A. L., & Mathew, S. J. (2014) · Depression and Anxiety · doi:10.1002/da.22253 · Cited by 345 · see citing works
Ketamine for rapid reduction of suicidal ideation: a randomized controlled trial
Murrough, J. W., Soleimani, L., DeWilde, K. E., Collins, K. A., Lapidus, K. A., Iacoviello, B. M., Lener, M., Kautz, M., Kim, J., Stern, J. B., et al. (2015) · Psychological Medicine · doi:10.1017/s0033291715001506 · Cited by 297 · see citing works
Hopelessness as a predictor of eventual suicide
BECK, A. T. (1986) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1986.tb27888.x · Cited by 282 · see citing works
The Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale
Bell, M. D., Milstein, R. M., Goulet, J. L., Lysaker, P. H., & Cicchetti, D. V. (1992) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199211000-00007 · Cited by 261 · see citing works
Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993-2008.
Ting, S. A., Sullivan, A. F., Boudreaux, E. D., Miller, I., & Camargo, C. A. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2012.03.020 · Cited by 252 · see citing works
MINI International Neuropsychiatric Schedule: clinical utility and patient acceptance
Pinninti, N. R., Madison, H., Musser, E., & Rissmiller, D. (2003) · European Psychiatry · doi:10.1016/j.eurpsy.2003.03.004 · Cited by 224 · see citing works
Deaths: Leading Causes for 2014.
Heron, M. P. (2016) · PubMed · Cited by 213 · see citing works
Ibrahim, L. A., Diazgranados, N., Luckenbaugh, D. A., Machado‐Vieira, R., Baumann, J., Mallinger, A. G., & Zarate, C. A. (2011) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2011.03.019 · Cited by 191 · see citing works
Bokor, G., & Anderson, P. (2014) · Journal of Pharmacy Practice · doi:10.1177/0897190014525754 · Cited by 165 · see citing works
Glenn, C. R., Kleiman, E. M., Cha, C. B., Deming, C. A., Franklin, J. C., & Nock, M. K. (2017) · Depression and Anxiety · doi:10.1002/da.22686 · Cited by 128 · see citing works
Antidepressant‐Induced Suicidality: An Update
Reeves, R. R., & Ladner, M. E. (2010) · CNS Neuroscience & Therapeutics · doi:10.1111/j.1755-5949.2010.00160.x · Cited by 118 · see citing works
Domany, Y., Bleich‐Cohen, M., Tarrasch, R., Meidan, R., Litvak-Lazar, O., Stoppleman, N., Schreiber, S., Bloch, M., Hendler, T., & Sharon, H. (2018) · The British Journal of Psychiatry · doi:10.1192/bjp.2018.196 · Cited by 114 · see citing works
Self-citationSuicide Intent Scale in the prediction of suicide
Stefánsson, J. G., Nordström, P., & Jokinen, J. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.11.016 · Cited by 111 · see citing works
A single infusion of ketamine improves depression scores in patients with anxious bipolar depression
Ionescu, D. F., Luckenbaugh, D. A., Niciu, M. J., Richards, E. M., & Zarate, C. A. (2014) · Bipolar Disorders · doi:10.1111/bdi.12277 · Cited by 104 · see citing works
Existing and Novel Biological Therapeutics in Suicide Prevention
Griffiths, J. J., Zarate, C. A., & Rasimas, J. J. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.06.012 · Cited by 94 · see citing works
County-Level Trends in Suicide Rates in the U.S., 2005–2015
Rossen, L. M., Hedegaard, H. B., Khan, D., & Warner, M. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.03.020 · Cited by 88 · see citing works
Assessing measures of suicidal ideation in clinical trials with a rapid-acting antidepressant
Ballard, E. D., Luckenbaugh, D. A., Richards, E. M., Walls, T. L., Brutsché, N. E., Ameli, R., Niciu, M. J., Vande Voort, J. L., & Zarate, C. A. (2015) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2015.06.003 · Cited by 80 · see citing works
Accelerating response to antidepressant treatment in depression: a review and clinical suggestions.
Nakajima, S., Suzuki, T., Watanabe, K., Kashima, H., & Uchida, H. (2010) · Progress in Neuro-psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2009.12.001 · Cited by 78 · see citing works
Burger, J., Capobianco, M., Lovern, R., Boche, B., Ross, E. M., Darracq, M. A., & McLay, R. N. (2016) · Military Medicine · doi:10.7205/milmed-d-15-00431 · Cited by 68 · see citing works
Routine use of the Beck Scale for Suicide Ideation in a psychiatric emergency department
Healy, D. J., Barry, K., Blow, F. C., Welsh, D. E., & Milner, K. K. (2006) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2006.04.003 · Cited by 49 · see citing works
Heiligenstein, J. H., Tollefson, G. D., & Faries, D. E. (1993) · International Clinical Psychopharmacology · doi:10.1097/00004850-199300840-00007 · Cited by 38 · see citing works
The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department Patients.
Kashani, P., Yousefian, S., Amini, A., Heidari, K., Younesian, S., & Hatamabadi, H. (2014) · Archives of Academic Emergency Medicine · doi:10.22037/aaem.v2i1.20 · Cited by 25 · see citing works
Ketamine for Treatment of Suicidal Ideation and Reduction of Risk for Suicidal Behavior
Mallick, F., & McCullumsmith, C. B. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0680-7 · Cited by 22 · see citing works
Self-citationThe association between traumatic brain injury and ADHD in a Canadian adult sample
Ilie, G., Vingilis, E. R., Mann, R. E., et al. (2015) · TSpace (University of Toronto) · doi:10.1016/j.jpsychires · Cited by 22 · see citing works
D, M. F. M., Freeman, M. P., Flynn, M., Judge, H., Hoeppner, B. B., Cusin, C., Ionescu, D. F., Mathew, S. J., Chang, L. C., Iosifescu, D. V., et al. (2019) · Molecular Psychiatry · doi:10.1038/s41380-018-0311-2 · Cited by 18 · see citing works
Barbero (2014) · doi:10.1016/j · Cited by 1 · see citing works
Scale for Suicide Ideation: Psychometric properties of a self-report version
Beck, A. T., Steer, R. A., & Ranieri, W. F. (1988) · Journal of Clinical Psychology · doi:10.1002/1097-4679(198807)44:4
Flagged first, then by citations
Research works printed but not linked: 1
- [10]10. Bokor, G., & Anderson, P. D. (2014). Ketamine: An update on its abuse. Journal of Pharmacy Practice, 27(6), 582-586. https://doi.org/10.1177/ 0897190014525754
Cited by
Sorted by citations
McIntyre, R. S., Rosenblat, J. D., Nemeroff, C. B., Sanacora, G., Murrough, J. W., Berk, M., Brietzke, E., Dodd, S., Gorwood, P., Ho, R., et al. (2021) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.20081251 · Cited by 731 · see citing works
Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review
Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.20060864 · Cited by 577 · see citing works
Blinding and expectancy confounds in psychedelic randomized controlled trials
Muthukumaraswamy, S. D., Forsyth, A., & Lumley, T. (2021) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2021.1933434 · Cited by 324 · see citing works
Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms
Inserra, A., De Gregorio, D., & Gobbi, G. (2021) · Pharmacological Reviews · doi:10.1124/pharmrev.120.000056 · Cited by 232 · see citing works
Ketamine Treatment for Depression: A Review
Yavi, M., Lee, H., Henter, I. D., Park, L. T., & Zarate, C. A. (2022) · Discover Mental Health · doi:10.1007/s44192-022-00012-3 · Cited by 161 · see citing works
Xiong, J., Lipsitz, O., Chen-Li, D., Rosenblat, J. D., Rodrigues, N. B., Carvalho, I., Lui, L. M. W., Gill, H., Narsi, F., Mansur, R. B., et al. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.12.038 · Cited by 124 · see citing works
Ketamine in neuropsychiatric disorders: an update
Johnston, J. N., Kadriu, B., Kraus, C., Henter, I. D., & Zarate, C. A. (2024) · Neuropsychopharmacology · doi:10.1038/s41386-023-01632-1 · Cited by 108 · see citing works
Ketamine and esketamine in suicidal thoughts and behaviors: a systematic review
Jollant, F., Colle, R., Nguyen, T. M. L., Corruble, E., Gardier, A. M., Walter, M., Abbar, M., & Wagner, G. (2023) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253231151327 · Cited by 56 · see citing works
The rapid anti-suicidal ideation effect of ketamine: A systematic review
Hochschild, A., Grunebaum, M. F., & Mann, J. J. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106524 · Cited by 55 · see citing works
Conley, A. A., Norwood, A. E. Q., Hatvany, T. C., Griffith, J. D., & Barber, K. E. (2021) · Psychopharmacology · doi:10.1007/s00213-021-05825-8 · Cited by 39 · see citing works
Blinding and expectancy confounds in psychedelic randomised controlled trials
Muthukumaraswamy, S., Forsyth, A., & Lumley, T. (2021) · doi:10.31234/osf.io/q2hzm · Cited by 15 · see citing works
Shivanekar, S., Gopalan, P., Pizon, A., Spotts, C., Cruz, N., Lightfoot, M., Rohac, R., Baumeister, A., Griffo, A., Panny, B., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192113792 · Cited by 8 · see citing works
Li, J., Ma, L., Sun, H., Li, M., Cao, Y., Peng, Y., & Xu, J. (2025) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01920-x · Cited by 5 · see citing works
From psychache to neuroplasticity: A unified rescue-repair model of Ketamine’s anti-suicidal action
Domany, Y., & Solomon-Shashua, A. (2026) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2026.106804 · Cited by 2 · see citing works
Self-citationBarzkar, M., Alavi, K., Malakouti, K., Khajeh-Azad, M.-A., Barzkar, F., Jalali Nadoushan, A. H., & Lahiji, M. N. (2025) · BMC Research Notes · doi:10.1186/s13104-024-07029-7 · Cited by 1 · see citing works
“The largest effects in their study were observed in patients with bipolar disorder and the results were not significant for the depression subgroup [22].”
- Authors
- Domany, Y., Shelton, R. C., & McCullumsmith, C. B.
- Affiliations
- Tel Aviv University (IL)
- University of Alabama at Birmingham (US)
- University of Toledo (US)
- Corresponding author
- Domany, Yoav
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2019-11-16
- Volume
- 37
- Issue
- 3
- Pages
- 224-233
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2986872227
- Cited by
- 84
- References
- 52
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 18 · 2023: 17 · 2022: 18 · 2021: 12 · 2020: 4
- FWCI
- 5.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- ketamine, suicidal ideation, depression, emergency department, rapid-acting antidepressants, antisuicidal effects, intravenous infusion, treatment safety
- MeSH terms
- Major Depressive Disorder, Double-Blind Method, Emergency Service, Hospital, Humans, Ketamine, Psychiatric Status Rating Scales, Excitatory Amino Acid Antagonists, Suicidal Ideation
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