The Effect of a Single Dose of Intravenous Ketamine on Suicidal Ideation
令和7年2月12日|p.79
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The Effect of a Single Dose of Intravenous Ketamine on Suicidal Ideation: A Systematic Review and Individual Participant Data Meta-Analysis
Samuel T. Wilkinson ${}^{1,*}$, Sanjay J. Mathew ${}^{2}$ and Gerard Sanacora ${}^{1}$
${}^{1}$ Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA; gerard.sanacora@yale.edu
${}^{2}$ Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA; sanjay.mathew@bcm.edu
* Correspondence: samuel.wilkinson@yale.edu; Tel.: +1-203-737-2501
Academic Editor: Michael Bauer
Received: 21 November 2017; Accepted: 11 January 2018; Published: 16 January 2018
Abstract:
Background: Several studies have suggested that the glutamatergic modulator ketamine may reduce suicidal ideation in adults with major depression. However, these findings are based on secondary analyses from trials designed to evaluate antidepressant effects. Methods: We conducted a systematic review and individual participant data meta-analysis to determine if ketamine reduces suicidal ideation in adults with mood disorders. Results: Five randomized controlled trials met inclusion criteria ($n = 167$). Ketamine was associated with a significant reduction in suicidal ideation compared to control groups (Cohen’s $d = -0.48$, 95% CI $-0.85$ to $-0.11$, $p = 0.01$). This effect remained significant when controlling for concurrent changes in depressive severity. Conclusions: Ketamine rapidly reduces suicidal ideation in adults with mood disorders. The effect appears to be at least partially independent from its antidepressant effects.
Keywords:
suicide; suicidal ideation; ketamine; depression; bipolar disorder; meta-analysis