Citation

Oruch R, Pryme IF, Fasmer OB, Lund A. Minerva Psychiatry 2021; 62(3): 120-131.

Copyright

(Copyright © 2021)

DOI

10.23736/S2724-6612.21.02068-9

PMID

unavailable

Abstract

Suicidal ideas emerge as a consequence of major depression, failure of therapy, depressive stupor, treatment-resistant catatonia and prolonged severe mania of bipolar affective disorder; and these are sometimes difficult to treat. Urgent and efficient treatment is necessary in these cases where suicide can be a potential outcome. Suicidal ideations can also arise when antidepressants, especially those of the SSRItype without being gradually tapered, are abruptly discontinued by a mishap or lack of knowledge. In all such cases urgent solutions will be necessary to avoid these individuals from committing suicide. After institutionalizing the patient, psychiatrists have two potent methods that can be used to prevent suicide. These are electroconvulsive therapy and intravenous ketamine administration. Electroconvulsive therapy (as a physical means) has an absolute indication, especially in those cases mentioned above; however, it also has its own hazards. Ketamine as a biological means can give excellent relief and save these individuals from an impending risk of suicide. In expert hands ketamine should be favored over electroconvulsive therapy in these situations. The drug has a convenient route of administration. Here we have discussed all aspects of ketamine with special emphasis on clinical indications, pharmacology and how to treat intoxication. Psychiatrists, junior residents of psychiatric units and other psychiatric caregivers are considered as the main audience for this work. © 2021 The authors. All right reserved.

Language: en

Keywords

human; Suicide; Review; bipolar disorder; Depressive disorder; ketamine; psychiatry; suicidal ideation; depression; prevalence; central nervous system; Ketamine; intoxication; cocaine; vomiting; analgesic agent; antidepressant agent; fluoxetine; mirtazapine; tachycardia; venlafaxine; dopamine; electroconvulsive therapy; diazepam; cardiovascular system; trazodone; dependent personality disorder; nausea; hypersalivation; hypotension; muscle hypertonia; rash; hypertension; creatine kinase; grand mal epilepsy; nystagmus; gastrointestinal tract; anesthetic agent; biotransformation; airway obstruction; bradycardia; diplopia; dizocilpine; n methyl dextro aspartic acid; anaphylaxis; Anesthetics; respiratory system; myoglobin; larynx spasm; breathing rate; injection site rash; neuromuscular function; antidepressant activity; cognitive behavioral therapy; loss of appetite; vortioxetine; intracranial pressure; pharmacodynamic parameters; Receptors, N-methyl-D-aspartate