Citation

Lengvenyte A, Olié E, Courtet P. Curr. Psychiatry Rep. 2019; 21(12): e132.

Affiliation

Neuropsychiatry, Epidemiological and Clinical Research, INSERM, University of Montpellier, Montpellier, France. philippe.courtet@umontpellier.fr.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s11920-019-1108-y

PMID

31797066

Abstract

PURPOSE OF REVIEW: Suicidal behaviours are a challenge for a medical system and public health, partly due to the current lack of evidence-based, effective, rapid tools for suicidal crisis management. Ketamine and its enantiomer esketamine have raised hopes regarding this issue in the recent years. However, their efficacy in suicidal behaviours and mechanisms for it remain a topic of debate. RECENT FINDINGS: Subanesthetic ketamine doses rapidly, albeit transiently decrease suicidal ideation, with effects emerging within an hour and persisting up to a week. Current evidence points to various and not necessarily exclusive mechanisms for ketamine's antisuicidal action, including effects on neuroplasticity, inflammation, reward system and pain processing. Ketamine rapidly decreases suicidal ideation, but whether it leads to meaningful clinical outcomes past 1 week is unclear. Multiple putative mechanisms drive ketamine's antisuicidal action. Future studies will have to show long-term ketamine treatment outcomes and further elucidate its mechanisms of action.

Language: en

Keywords

Anhedonia; Inflammation; Ketamine; Neuronal plasticity; Suicidal ideation; Suicide