その他令和8年6月23日
静脈内ケタミンの単回投与が自殺念慮に与える影響：体系的レビューおよび個別参加者データメタ分析
出典：官報発行サイト（内閣府）の掲載情報をもとに整理しています。重要な確認は公式原文を基準にしてください。
出典・注意
官報発行サイト（内閣府）の掲載情報をもとに整理しています。重要な確認は公式原文を基準にしてください。
本文と原文の対照
まず左側の本文を読み、必要な箇所だけ原文ページで確認できる構成です。
← 同日の官報に戻る
原文対照の表示オプション
静脈内ケタミンの単回投与が自殺念慮に与える影響：体系的レビューおよび個別参加者データメタ分析
左の本文を選ぶと、右側の官報原文画像で該当箇所を照合できます。
The Effect of a Single Dose of Intravenous Ketamine on Suicidal Ideation: A Systematic Review and Individual Participant Data Meta-Analysis
Samuel T. Wilkinson 1,2,* , Elizabeth D. Ballard 2 , Mark H. Bloch 1,2 , Gerard Sanacora 1,2 ,
Nadia Ameli 3 , Ahmed M. Al Jurdi 4 , Ali Fouladi 5 , Carlos A. Zarate Jr. 2 and
Glenn Treisman 6
1 Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA;
mark.bloch@yale.edu (M.H.B.); gerard.sanacora@yale.edu (G.S.)
2 Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health,
National Institutes of Health, Bethesda, MD 20892, USA; elizabeth.ballard@nih.gov (E.D.B.);
nadia.ameli@nih.gov (N.A.); zaratec@mail.nih.gov (C.A.Z.J.)
3 Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
4 Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA;
aljurdi@bcm.edu
5 Department of Psychiatry, University of California Los Angeles, Los Angeles, CA 90095, USA;
afouladi@mednet.ucla.edu
6 Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA;
gtreissm@jhmi.edu
* Correspondence: samuel.wilkinson@yale.edu; Tel.: +1-203-737-2246
Received: 1 December 2017; Accepted: 10 January 2018; Published: 12 January 2018
Abstract:
Suicide is a public health crisis with limited treatment options. While clinical evidence remains limited, ketamine has been increasingly studied for its potential antidepressant and anti-suicidal effects. This systematic review and individual participant data meta-analysis examines the effects of a single dose of intravenous ketamine on suicidal ideation. We performed a systematic literature search to identify studies that examined the effect of ketamine on suicidal ideation. Authors were contacted for individual participant data. Change in suicidal ideation severity was measured using mixed-effects repeated measures models examining each time point from 4 h through 7 days post-infusion. The interaction between baseline depression severity and change in suicidal ideation was also examined. Nine studies with a total of 185 participants were included in the analysis. There was a significant reduction in suicidal ideation severity at 24 h (Cohen’s d = 0.82, p < 0.001), which remained significant through day 7 (Cohen’s d = 0.75, p < 0.001). Furthermore, there was an interaction between baseline depression severity and change in suicidal ideation at day 1 (p = 0.01) and day 3 (p = 0.02). Individuals with more severe depressive symptoms demonstrated greater reductions in suicidal ideation. The results indicate that a single infusion of intravenous ketamine may result in a rapid decrease in suicidal ideation in individuals with mood disorders.
Keywords:
suicide; suicidal ideation; ketamine; meta-analysis; depression; bipolar disorder
1. Introduction
Suicide is a major public health concern, accounting for nearly one million deaths worldwide annually [1]. In the United States alone, suicide rates have increased by 24% over the past 15 years, making it the tenth leading cause of death overall [2]. Despite this increase, there are no Food and Drug Administration (FDA)-approved treatments specifically targeting suicidal behavior or suicidal ideation. Current interventions for suicidality include pharmacotherapy, psychotherapy, electroconvulsive therapy (ECT), and hospitalization. However, these interventions often take weeks to months to achieve therapeutic benefit, leaving a critical gap in care for those at imminent risk.
Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has emerged as a promising rapid-acting antidepressant. Multiple randomized controlled trials have demonstrated that a single subanesthetic dose of intravenous ketamine can produce rapid and robust antidepressant effects within hours, lasting up to one week [3–5]. Given the strong association between depression and suicide, researchers have begun to investigate whether ketamine's rapid antidepressant effects extend to reducing suicidal ideation. Early case reports and small open-label studies suggested that ketamine might rapidly reduce suicidal thoughts, even in patients who had not responded to other treatments [6,7].
However, the existing literature on ketamine and suicidality is heterogeneous, with varying methodologies, sample sizes, and outcome measures. Some studies report dramatic reductions in suicidal ideation, while others show more modest or non-significant effects. Furthermore, many studies have focused primarily on antidepressant outcomes, with suicidality assessed as a secondary measure. To clarify the current state of evidence, we conducted a systematic review and individual participant data (IPD) meta-analysis to examine the effect of a single dose of intravenous ketamine on suicidal ideation across multiple studies.
This approach allows us to pool raw data from individual participants, providing greater statistical power and enabling more nuanced analyses than traditional aggregate-data meta-analyses. Specifically, we aimed to: (1) quantify the magnitude and duration of ketamine's effect on suicidal ideation; (2) examine whether baseline depression severity moderates this effect; and (3) assess the consistency of findings across different study designs and populations.
読み込み中...
テキスト領域
選択中
非公開 (PII)
関連する新着公告を見逃さないために
Pro プランでは会社名・機関名・キーワードを監視条件として保存し、新着掲載を継続確認できます。14日間無料で試せます。
監視機能の詳細を見る →