Ketamine could reduce suicidal ideation for people diagnosed with treatment-resistant depression (TRD) if used in small controlled doses, Taiwanese researchers said on Thursday.
When taken in small doses, ketamine could act as an antidepressant in just a few hours, and could act as a “filler” medication to take alongside traditional medication prescribed to fight depression, Cheng Hsin General Hospital physician Su Tung-ping (蘇東平) told a news conference at the hospital when presenting their findings.
People who were part of a study presented in the paper were ranked according to Item 10 of the Montgomery-Asberg Depression Rating Scale (MADRS), with a 4 meaning “the person feels they’d be better off dead; suicidal thoughts common and considered as a possible solution, but no specific plans/intention,” and a 6 meaning “the person has explicit plans for suicide; active preparations,” Su said. The study recruited outpatients, comprised of 59 women and 20 men, who have TRD and prominent suicidal ideation, and randomized them into two groups to receive 0.5mg/kg of ketamine or 0.045mg/kg of Midazolam, Su said.
Photo: CNA
The study results support the use of rapid antidepressant and antisuicidal effects of low-dose ketamine infusion in people with TRD and prominent suicidal ideation, Su said.
The antidepressant effect of ketamine persisted for up to two weeks, but the antisuicidal effect lasted only five days, Su said.
Su said that the timing of ketamine treatment was crucial.
Patients with moderate or low treatment refractoriness or drug responsiveness, current depressive episodes that have persisted for less than 24 months, or less than or equal to four failed antidepressant treatments, might receive the greatest benefits from low-dose ketamine infusion, he said.
Cerebral tomography of patients before the use of ketamine showed low metabolization in the frontal lobe, which became more active after the injection of ketamine, Su said.
Some TRD patients might entertain suicidal thoughts from the moment they wake up every day, adding that this research could help inhibit such thoughts and make them “want to live,” Taipei Veterans General Hospital Department of Psychiatry physician Chen Mu-hong (陳牧宏) said.
Su also said that as only minute doses of ketamine were used on an infrequent basis, no person has experienced addiction to ketamine, adding that even people undergoing an intense treatment of three infusions a week for several consecutive weeks were “still manageable.”
The study was featured in Volume 26, Issue 5 of the International Journal of Neuropsychopharmacology, published in May.
Additional reporting by CNA
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