Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial
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Abstract
OBJECTIVE: This study aimed to evaluate the efficacy of a single infusion of ketamine in inducing rapid remission of severe suicidal ideation, compared to Midazolam, in a population with acute suicidal thoughts. In a double-blind randomized controlled trial conducted in Tehran, Iran, from January to July 2022 (IRCT20220118053756N1), 36 inpatients with acute severe suicidal ideation were enrolled. Participants were randomly assigned to receive either a single dose of ketamine (0.5 mg/kg) or Midazolam (0.02 mg/kg). Suicidality was assessed using the Beck Scale for Suicide Ideation (BSSI) and the Suicide-Visual Analog Scale (S-VAS) before the intervention and at 12 and 24 h post-administration. RESULTS: At baseline, the Midazolam group exhibited significantly higher BSSI scores and a higher rate of borderline personality disorder than the Ketamine group. Mean BSSI and S-VAS scores at 12 and 24 h after the treatment decreased significantly compared to baseline in both groups. Despite these observations, no statistically significant differences were found between the groups in terms of BSSI and S-VAS scores. TRIAL REGISTRATION: The protocol for this RCT was registered at the Iranian Registry of Clinical Trials (IRCT). The trial registration details are as follows: IRCT registration number IRCT20220118053756N1, with the registration date being June 12, 2022 (1401/03/22). It is important to note that this trial was retrospectively registered.
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- Authors
- Barzkar, M., Alavi, K., Malakouti, K., Khajeh-Azad, M.-A., Barzkar, F., Jalali Nadoushan, A. H., & Lahiji, M. N.
- Affiliations
- Iran University of Medical Sciences (IR)
- Venue
- BMC Research Notes
- Published
- 2025-02-12
- Volume
- 18
- Issue
- 1
- Pages
- 65-65
- ISSN
- 1756-0500 (ISSN-L)
- PMC
- PMC11823077
- OpenAlex
- W4407423713
- Cited by
- 1
- References
- 23
- Citations by year
- 2026: 1
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Research Notes (publishedVersion, cc-by-nc-nd)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- ketamine, suicidal ideation, midazolam, rapid remission, borderline personality disorder, suicide risk, single-dose infusion, Beck Scale for Suicide Ideation
- MeSH terms
- Adult, Double-Blind Method, Emergency Service, Hospital, Female, Humans, Iran, Ketamine, Male, Midazolam, Middle Aged, Pilot Projects, Treatment Outcome, Young Adult, Suicidal Ideation
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