Time magazine has a cover story (August 7, 2017) titled:
“THE ANTI
ANTIDEPRESSANT
Depression afflicts 16 million Americans.
One third don’t respond to treatment
A surprising new drug may change that”
The drug in question is ketamine. Will ketamine stop suicidal thoughts better than traditional antidepressants?
When someone is suicidal seconds count!
Q. Is ketamine infusion safe for the elderly? My son’s mother-in-law (age 69) has been diagnosed with major depression. She has made two suicide attempts.
I am not sure what she is taking now, but she seems apathetic, worries about everything and interacts inappropriately with family. She is almost completely unresponsive to her grandchildren. This is a total change from her personality five years ago, when she was devoted to her family and engaged with the world.
A. Major depression takes a terrible toll on the individual, family and friends. Suicide attempts are a clear signal that your son’s mother-in-law is desperate and requires expert medical intervention.
Ketamine (Ketalar) is a fascinating drug that has been used since 1962 as a general anesthetic. Over the last several years researchers have discovered that this medication has profound antidepressant activity that kicks in within hours instead of the usual weeks of standard drugs. When someone is suicidal it is dangerous to wait weeks for an antidepressant drug to work.
Will Ketamine Stop Suicidal Thoughts?
A recent meta-analysis found that ketamine is effective in reducing suicidal ideation within four hours (Neuroscience and Biobehavioral Reviews, June 2017). Unfortunately, research has not yet shown how long this effect may last.
This isn’t the first assessment of ketamine in the treatment of suicidal thoughts.
Here are some other reports in the medical literature:
“Sublingual (under the tongue) Ketamine for Rapid Relief of Suicidal Ideation”:
“These cases demonstrate that low doses of sublingual ketamine repeated over a span of hours can induce rapid remission of suicidality in unipolar or bipolar depression.
“Chronic use of oral or sublingual ketamine has been helpful in the past 4 years for many of my patients with mild depressive symptoms.
“Sublingual ketamine may be a practical option for managing suicidality in outpatients as an adjunct to traditional antidepressants and mood stabilizers and could shorten the hospital stay of psychiatric inpatients. Sublingual ketamine is worthy of systematic study as a treatment to provide rapid relief of suicidal ideation.”
Reduction in Suicidal Ideation Following Repeated Doses of Intravenous Ketamine?
…”the evidence to date supporting the clinical use of ketamine as antisuicidal treatment is extremely preliminary, and on the basis of the article by Ionescu et al, conclusions concerning the effects of ketamine on suicidal ideation should be drawn with caution.”
“Cancer patients experience increased risk and incidence of suicide and other psychiatric disorders.
“In the past 10 years, evidence has emerged showing that sub-anesthetic doses of ketamine (0.5 mg/kg) induce fast-acting antidepressant effects on depressed patients. Antidepressant effects of ketamine were observed as soon as 40 min after infusion and typically lasted at most for 7 days, with some patients experiencing more prolonged mood improvement.
” Collectively, this study provides novel information about the rapid antidepressant effect of ketamine on acute depression and suicidal ideation in newly-diagnosed cancer patients.”
“Ketamine for Treatment of Suicidal Ideation and Reduction of Risk for Suicidal Behavior”
(in Current Psychiatry Reports, June, 2016).
“Our review concludes that ketamine treatment can be seen as a double-edged sword, clinically to help provide treatment for acutely suicidal patients and experimentally to explore the neurobiological nature of suicidal ideation and suicidal behavior.”
Ketamine and Your Mother-In-Law:
There is inadequate research on ketamine infusion in older patients (Expert Opinion on Pharmacotherapy, April 2017). Since this medication may alter blood pressure and heart rate, the latest recommendations from the American Psychiatric Association call for monitoring so that immediate care may be provided if necessary (JAMA Psychiatry, April 1, 2017).
More articles from The People’s Pharmacy about whether Ketamine can stop suicidal thoughts are available at these links:
Can Ketamine Jump Start Antidepressant Action?
Radio Show # 983 (FREE): Intriguing Approaches to Overcoming Depression
