Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA 15213, USA.
Department of Emergency Medicine, Division of Medical Toxicology, University of Pittsburgh, 3600 Forbes at Meyran Avenue, Forbes Tower, Suite 10028, Pittsburgh, PA 15213, USA.
Int J Environ Res Public Health. 2022 Oct 24;19(21):13792. doi: 10.3390/ijerph192113792.
Ketamine, in research settings, rapidly reduces suicidal thoughts 2-24 h after a single infusion in patients with high suicidal ideation. In this study, the authors investigate ketamine's effects on suicidality in a real-world sample of recent suicide attempters on a tertiary-care Consultation-Liaison (CL) psychiatry service. Using an open-label design, 16 transdiagnostic CL patients were recruited, 18-65 years old, to receive a single dose of intravenous ketamine (0.5 mg/kg) in the acute medical setting. All were psychiatrically hospitalized post-infusion. Baseline suicidality and depression measures were compared to ratings taken at 24 h, 5 days, 12 days, and 1, 3 and 6 months post-infusion using paired t-tests. Across all measures, rapid, statistically significant decreases ('s < 0.001) were observed with large to very large effect sizes (Cohen's 's: 1.7-8.8) at acute timepoints (24 h; 5 days). These gains were uniformly maintained to 6 months post-infusion. Open-label ketamine appeared to rapidly and robustly reduced suicidal symptoms in an ultra-high-risk, heterogeneous, real-world sample. Ketamine infusion may therefore be a safe, feasible, viable method to rapidly reduce suicidality among medically hospitalized patients after a suicide attempt, with potentially enduring benefits. The current pilot findings suggest ketamine could be readily integrated into the settings where high-risk CL patients already receive healthcare, with the potential to become an important and novel tool in the treatment of suicidality.
氯胺酮在研究环境中，在单次输注后 2-24 小时内迅速降低有高自杀意念的患者的自杀念头。在这项研究中，作者调查了氯胺酮在三级医疗联络精神病学服务中心最近自杀未遂的现实样本中的自杀倾向的影响。使用开放标签设计，招募了 16 名跨诊断联络精神病学患者，年龄在 18-65 岁之间，在急性医疗环境中接受单次静脉注射氯胺酮（0.5mg/kg）。所有患者在输注后都被精神病住院。使用配对 t 检验将基线自杀倾向和抑郁测量值与输注后 24 小时、5 天、12 天、1 个月、3 个月和 6 个月的评分进行比较。在所有测量中，在急性时间点（24 小时；5 天）观察到快速、具有统计学意义的下降（s < 0.001），具有大到非常大的效应量（Cohen 的 s：1.7-8.8）。这些收益在输注后 6 个月内保持一致。开放标签氯胺酮似乎在超高危、异质的现实样本中迅速而有力地降低了自杀症状。因此，氯胺酮输注可能是一种安全、可行、可行的方法，可在自杀未遂后迅速降低住院患者的自杀倾向，具有潜在的持久益处。目前的初步研究结果表明，氯胺酮可以很容易地整合到高风险联络精神病学患者已经接受医疗保健的环境中，有可能成为治疗自杀倾向的重要和新颖工具。
