Suicide Has Many Faces, So Does Ketamine: a Narrative Review on Ketamine’s Antisuicidal Actions
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.
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.
KeywordsKetamine Suicide Suicidal ideation Neuronal plasticity Inflammation Anhedonia
Compliance with Ethical Standards
Conflict of Interest
Aiste Lengvenyte declares no potential conflicts of interest.
Emilie Olié has received personal fees from Janssen Cilag and Otsuka.
Philippe Courtet has received personal fees from Janssen, Otuska and Exeltis.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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