Intravenous Ketamine in Suicidal Ideation in Depression

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BSTRACT

Major depressive disorder is commonly associated with suicidal ideation, while conventional antidepressants have a delayed onset of action. Ketamine has emerged as a rapid-acting antidepressant with potential anti-suicidal effects. This retrospective case series evaluated the effectiveness and tolerability of intravenous ketamine in patients with major depressive disorder and active suicidal ideation. Four adult patients received intravenous ketamine (0.5 mg/kg over 40 minutes) alongside ongoing antidepressant treatment. Suicidal ideation and depressive severity were assessed using the Beck Scale for Suicide Ideation and the Hamilton Depression Rating Scale. All patients showed rapid reduction in suicidal ideation within hours to days, with improvement in depressive symptoms. Adverse effects were mild and transient. Intravenous ketamine appears to be a rapid and well-tolerated option for acute reduction of suicidal ideation, warranting further controlled studies.