The Impact of Single-Dose IV Ketamine and IN Esketamine in Those With Major Depression and Bipolar Disorder

There have been prior reports of the efficacy of ketamine in reducing suicidal ideation (SI). Researchers evaluated the anti-SI effect of single-dose ketamine in several formulations and routes of administration from looking at the results from randomized controlled trials until July 1, 2020. Selected studies were based on previously established eligibility criteria. Random-effects models were utilized in computing effect sizes of various formulations and routes at different points of time. Nine randomized controlled trials were eligible (n = 197), and the pooled effect size for anti-SI effect at 24 hours was 1.035 with intravenous (IV) ketamine compared with 1.309 with intranasal (IN) esketamine. A qualitative analysis was performed using an additional 5 randomized controlled trials. It was found that single-dose IV ketamine/IN esketamine are correlated with significant decreases in suicidal thoughts at 2, 4, and 24 hours following intervention.

Reference:

Xiong J, Lipsitz O, Chen-Li D, et al. The acute antisuicidal effects of single-dose intravenous ketamine and intranasal esketamine in individuals with major depression and bipolar disorders: A systematic review and meta-analysis. J Psychiatr Res. 2021;134:57-68. doi:10.1016/j.jpsychires.2020.12.038

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