TY  - JOUR
PY  - 2010//
TI  - Rapid resolution of suicidal ideation after a single infusion of an N-methyl-D-aspartate antagonist in patients with treatment-resistant major depressive disorder
JO  - Journal of clinical psychiatry
A1  - Diazgranados, Nancy
A1  - Ibrahim, Lobna A.
A1  - Brutsche, Nancy E.
A1  - Ameli, Rezvan
A1  - Henter, Ioline D.
A1  - Luckenbaugh, David A.
A1  - Machado-Vieira, Rodrigo
A1  - Zarate, Carlos A.
SP  - 1605
EP  - 1611
VL  - 71
IS  - 12
N2  - OBJECTIVE: Suicidal ideation is a medical emergency, especially when severe. Little research has been done on pharmacologic interventions that could address this problem. Ketamine, an N-methyl-D-asparate antagonist, has been reported to have antidepressant effects within hours. We examined the effects of a single dose of ketamine on suicidal ideation in subjects with treatment-resistant major depressive disorder (MDD).  METHOD: Thirty-three subjects with DSM-IV-diagnosed MDD received a single open-label infusion of ketamine (0.5 mg/kg) and were rated at baseline and at 40, 80, 120, and 230 minutes postinfusion with the Scale for Suicide Ideation (SSI), the Montgomery-Åsberg Depression Rating Scale, the Hamilton Depression Rating Scale, and the Beck Depression Inventory. The study was conducted between October 2006 and January 2009.  RESULTS: Suicidal ideation scores decreased significantly on the SSI as well as on the suicide subscales of other rating instruments within 40 minutes; these decreases remained significant through the first 4 hours postinfusion (P <.001). Ten subjects (30%) had an SSI score ≥ 4 at baseline; all these scores dropped below 4 (9 dropped by 40 minutes and 1 by 80 minutes). For those patients with a starting score below 4 on the SSI, only 1 reached a score of 4. Depression, anxiety, and hopelessness were significantly improved at all time points (P <.001).  CONCLUSIONS: Suicidal ideation in the context of MDD improved within 40 minutes of a ketamine infusion and remained improved for up to 4 hours postinfusion. Future studies with ketamine in suicidal ideation are warranted due to the potential impact on public health.  TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00088699.<p /> <p>Language: en</p>
LA  - en
SN  - 0160-6689
UR  - http://dx.doi.org/10.4088/JCP.09m05327blu
ID  - ref1
ER  -