Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial

Abstract Objective This study aimed to evaluate the efficacy of a single infusion of ketamine in inducing rapid remission of severe suicidal ideation, compared to Midazolam, in a population with acute suicidal thoughts. In a double-blind randomized controlled trial conducted in Tehran, Iran, from Ja...

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Main Authors: Maryam Barzkar, Kaveh Alavi, Kazem Malakouti, Mohamad-Amin Khajeh-Azad, Farzaneh Barzkar, Amir Hossein Jalali Nadoushan, Mohammad Niakan Lahiji
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Research Notes
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Online Access:https://doi.org/10.1186/s13104-024-07029-7
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author Maryam Barzkar
Kaveh Alavi
Kazem Malakouti
Mohamad-Amin Khajeh-Azad
Farzaneh Barzkar
Amir Hossein Jalali Nadoushan
Mohammad Niakan Lahiji
author_facet Maryam Barzkar
Kaveh Alavi
Kazem Malakouti
Mohamad-Amin Khajeh-Azad
Farzaneh Barzkar
Amir Hossein Jalali Nadoushan
Mohammad Niakan Lahiji
author_sort Maryam Barzkar
collection DOAJ
description Abstract Objective This study aimed to evaluate the efficacy of a single infusion of ketamine in inducing rapid remission of severe suicidal ideation, compared to Midazolam, in a population with acute suicidal thoughts. In a double-blind randomized controlled trial conducted in Tehran, Iran, from January to July 2022 (IRCT20220118053756N1), 36 inpatients with acute severe suicidal ideation were enrolled. Participants were randomly assigned to receive either a single dose of ketamine (0.5 mg/kg) or Midazolam (0.02 mg/kg). Suicidality was assessed using the Beck Scale for Suicide Ideation (BSSI) and the Suicide-Visual Analog Scale (S-VAS) before the intervention and at 12 and 24 h post-administration. Results At baseline, the Midazolam group exhibited significantly higher BSSI scores and a higher rate of borderline personality disorder than the Ketamine group. Mean BSSI and S-VAS scores at 12 and 24 h after the treatment decreased significantly compared to baseline in both groups. Despite these observations, no statistically significant differences were found between the groups in terms of BSSI and S-VAS scores. Trial registration The protocol for this RCT was registered at the Iranian Registry of Clinical Trials (IRCT). The trial registration details are as follows: IRCT registration number IRCT20220118053756N1, with the registration date being June 12, 2022 (1401/03/22). It is important to note that this trial was retrospectively registered.
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spelling doaj-art-e17615504dc34d488c50edb815b56c412025-08-20T02:48:11ZengBMCBMC Research Notes1756-05002025-02-011811710.1186/s13104-024-07029-7Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trialMaryam Barzkar0Kaveh Alavi1Kazem Malakouti2Mohamad-Amin Khajeh-Azad3Farzaneh Barzkar4Amir Hossein Jalali Nadoushan5Mohammad Niakan Lahiji6Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical SciencesMental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences Geriatric Mental Health Research Center, Iran University of Medical SciencesMental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical SciencesNational Brain Centre, Iran University of Medical SciencesMental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences Trauma and Injury Research Center, School of Medic, Iran University of Medical SciencesAbstract Objective This study aimed to evaluate the efficacy of a single infusion of ketamine in inducing rapid remission of severe suicidal ideation, compared to Midazolam, in a population with acute suicidal thoughts. In a double-blind randomized controlled trial conducted in Tehran, Iran, from January to July 2022 (IRCT20220118053756N1), 36 inpatients with acute severe suicidal ideation were enrolled. Participants were randomly assigned to receive either a single dose of ketamine (0.5 mg/kg) or Midazolam (0.02 mg/kg). Suicidality was assessed using the Beck Scale for Suicide Ideation (BSSI) and the Suicide-Visual Analog Scale (S-VAS) before the intervention and at 12 and 24 h post-administration. Results At baseline, the Midazolam group exhibited significantly higher BSSI scores and a higher rate of borderline personality disorder than the Ketamine group. Mean BSSI and S-VAS scores at 12 and 24 h after the treatment decreased significantly compared to baseline in both groups. Despite these observations, no statistically significant differences were found between the groups in terms of BSSI and S-VAS scores. Trial registration The protocol for this RCT was registered at the Iranian Registry of Clinical Trials (IRCT). The trial registration details are as follows: IRCT registration number IRCT20220118053756N1, with the registration date being June 12, 2022 (1401/03/22). It is important to note that this trial was retrospectively registered.https://doi.org/10.1186/s13104-024-07029-7SuicideKetamineMidazolamN-methyl-d-aspartate receptor antagonistDepressive disorder
spellingShingle Maryam Barzkar
Kaveh Alavi
Kazem Malakouti
Mohamad-Amin Khajeh-Azad
Farzaneh Barzkar
Amir Hossein Jalali Nadoushan
Mohammad Niakan Lahiji
Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial
BMC Research Notes
Suicide
Ketamine
Midazolam
N-methyl-d-aspartate receptor antagonist
Depressive disorder
title Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial
title_full Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial
title_fullStr Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial
title_full_unstemmed Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial
title_short Is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting? Lessons learned from a pilot randomized controlled trial
title_sort is ketamine efficacious for rapid treatment of acute suicidal ideation in an emergency setting lessons learned from a pilot randomized controlled trial
topic Suicide
Ketamine
Midazolam
N-methyl-d-aspartate receptor antagonist
Depressive disorder
url https://doi.org/10.1186/s13104-024-07029-7
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