A Pilot Study of Ketamine Infusion after Suicide Attempt: New Frontiers in Treating Acute Suicidality in a Real-World Medical Setting

Sharvari Shivanekar, Priya Gopalan, Anthony Pizon, Crystal Spotts, Nicolas Cruz, Michael Lightfoot, Rebecca Rohac, Andrew Baumeister, Angela Griffo, Benjamin Panny, Shelly Kucherer, Alex Israel, Manivel Rengasamy and Rebecca Price ()
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Sharvari Shivanekar: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Priya Gopalan: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Anthony Pizon: Department of Emergency Medicine, Division of Medical Toxicology, University of Pittsburgh, 3600 Forbes at Meyran Avenue, Forbes Tower, Suite 10028, Pittsburgh, PA 15213, USA
Crystal Spotts: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Nicolas Cruz: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Michael Lightfoot: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Rebecca Rohac: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Andrew Baumeister: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Angela Griffo: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Benjamin Panny: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Shelly Kucherer: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Alex Israel: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Manivel Rengasamy: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA
Rebecca Price: Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213, USA

IJERPH, 2022, vol. 19, issue 21, 1-15

Abstract: 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 ( p ’s < 0.001) were observed with large to very large effect sizes (Cohen’s d ’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.

Keywords: suicide; suicidal ideation; suicide attempt; intravenous ketamine; consultation-liaison psychiatry; medical toxicology; tertiary care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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