Ketamine is a long known anesthetic agent that is still used for induction anesthesia in medicine today. It is also used off label for the treatment of various treatment-resistant diseases ranging from depression to various pain disorders. For the treatment of pain, intravenous ketamine has proven successful in countless case studies and numerous placebo-controlled clinical trials. Interestingly, ketamine has gained much attention in the media recently as a possible treatment for depression. Since originally reported as efficacious in certain cases of depression, it has proven successful in subtypes of this disease, like post-traumatic stress disorder (PTSD).
Although suicidality (suicidal thoughts) is commonly expected to accompany depression, this is not always the case. The two diseases are clinically different as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM). Interestingly, a recent clinical study aimed to assess the efficacy of intravenous (IV) ketamine for the treatment of suicidal cognition in symptomatic patients with treatment-resistant unipolar major depression. The patients that were entered into this trial had inadequate responses to more than three other antidepressant medications. Interestingly, there is currently no FDA-approved drug for the treatment of suicidality. A team of researchers from the University of Pittsburgh, Icahn School of Medicine at Mount Sinai, Baylor College of Medicine, and the Michael E. Debakey VA Medical Center conducted a placebo controlled clinical trial to evaluate the efficacy of intravenous ketamine for the treatment of suicidality. Fifty seven patients completed the trial and were assessed by the researchers using a composite index of explicit suicidal ideation. A psychoactive placebo, midazolam, was used.
The researchers published their findings in the journal of Depression and Anxiety. They found that the intravenous ketamine group had rapid reductions in suicidal cognition “over and above” the active placebo group. This finding could be critical for the development of an FDA-approved medication for the treatment of suicidality, a would-be first for this indication. The researchers concluded that their findings warrant further study into ketamine’s antisuicidal effects in higher-risk patients.
Intravenous ketamine is offered at the Florida Spine Institute by Dr. Ashraf Hanna’s clinical team. Dr. Hanna has achieved great success using IV ketamine for the treatment of many diseases that fail to respond adequately to conventional therapies. To find out if this therapy might be right for you, please make an appointment to see Dr. Hanna.