Kutz Craig J, Mistry Amit M, Dukes Charles H
Aerosp Med Hum Perform. 2025 Jun;96(6):509-519. doi: 10.3357/AMHP.6619.2025.
The transition to exploration missions places a heightened risk on behavioral health in spaceflight. Although serious psychiatric emergencies during spaceflight have been rare, longer duration missions increase the possibility of emergence in latent mental health disorders due to genetic predisposition, increased autonomy, isolation, helplessness, loss of family member, or catastrophic events. Complicated grief and bereavement have the highest rate of suicidal ideation. Recently, ketamine has been used as an emergent intervention for acute suicidality, promoting its stability, ease of administration, favorable safety profile, and outcomes for reduction of suicidal intent. The goal of this study was to review current literature and collate the understanding of ketamine as a safe, effective pharmacological adjunct for acute suicidality in spaceflight.
This literature review was conducted to collate data on ketamine use for acute suicidality and inform on stability, limitations, and utilization of ketamine within extreme environments.
There were 122 publications reviewed for relevance, including 23 randomized-control trials for ketamine use in behavioral emergencies.
Ketamine is a diverse pharmaceutical with multiple advantageous indications, including acute suicidality, pain, and sedation. Terrestrial use of ketamine suggests a rapidly efficacious medication for reduction in acute suicidality. As behavioral stressors expand related to extended missions, contingencies for behavioral emergencies become increasingly important. Although this review is not intended to redevelop current International Space Station protocols, it is the first to discuss the benefits of ketamine in spaceflight as a potential safe, effective, multifaceted tool for exploration missions and treatment for acute suicidal ideation. Kutz CJ, Mistry AM, Dukes CH. Expanding ketamine application for treatment of acute suicidality in long-duration spaceflight. Aerosp Med Hum Perform. 2025; 96(6):509-519.
向探索任务的转变给太空飞行中的行为健康带来了更高风险。尽管太空飞行期间严重的精神科紧急情况很少见，但长时间任务会增加因遗传易感性、自主性增加、孤立、无助、家庭成员离世或灾难性事件而导致潜在心理健康障碍出现的可能性。复杂的悲伤和丧亲之痛的自杀意念发生率最高。最近，氯胺酮已被用作急性自杀行为的紧急干预药物，因其具有稳定性、易于给药、良好的安全性以及降低自杀意图的效果。本研究的目的是回顾当前文献，并整理对氯胺酮作为太空飞行中急性自杀行为安全、有效药物辅助手段的理解。
进行本次文献综述以整理关于氯胺酮用于急性自杀行为的数据，并了解其在极端环境中的稳定性、局限性和应用情况。
共审查了122篇相关出版物，其中包括23项氯胺酮用于行为紧急情况的随机对照试验。
氯胺酮是一种具有多种优势适应症的多功能药物，包括急性自杀行为、疼痛和镇静。在地球上使用氯胺酮表明它是一种能快速有效降低急性自杀行为的药物。随着与长期任务相关的行为压力源不断增加，应对行为紧急情况的应急措施变得越来越重要。尽管本综述并非旨在重新制定当前国际空间站的方案，但它是首次讨论氯胺酮在太空飞行中的益处，即作为探索任务和治疗急性自杀意念的潜在安全、有效、多方面的工具。库茨CJ、米斯特里AM、杜克斯CH。扩大氯胺酮在长期太空飞行中治疗急性自杀行为的应用。航空航天医学与人类表现。2025；96(6):509 - 519。
