Systematic review and individual participant data meta-analysis examining the effects of a single dose of katamine on suicidal ideation. The review included 10 RCTs that compared a single dose of ketamine to control (either saline or midazolam). The analysis only included patients with suicidal ideation at baseline (n=167). Primary outcome measures of degree of suicidality was obtained from clinician-administered Montgomery-Asberg Depression Rating Scale (MADRS) or Hamilton Depression Rating Scale (HAM-D) and self-reported scales – Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) or Beck Depression Inventory (BDI), for up to one week post-ketamine administration.

• Ketamine reduced suicidal ideation more rapidly than was observed in the control group, with significant benefits appearing as early as day 1 and extending up to day 7
• The benefits of ketamine compared to control remained significant after baseline covariates (age, gender, race, use of concomitant psycotropic medications, outpatient vs. inpatient status, diagnosis)
• Mean Montgomery-Asberg Depression Rating Scale (MARDS) scores for the group exposed to ketamine were 33.8 (6.8) at baseline, 19.5 (12.3) at Day 1, 19.4 (12.1) at Day 2, 20.1 (12.2) at Day 2, and 22.0 (11.5) at Day 7
• Mean MARDS scores for the group exposed to control were 32.9 (6.5) at baseline, 29.2 (9.3) at Day 1, 29.1 (10.5) at Day 2, 27.3 (9.8) at Day 3, and 27.5 (10.0) at Day 7
• These results suggest ketamine’s beneficial effects on suicidal ideation hold considerable promise, however more robust studies are needed to determine ketamine’s safety and efficacy in patients with mood disorders and suicidal ideation

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