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Current Psychiatry Reports

, 21:132 | Cite as

Suicide Has Many Faces, So Does Ketamine: a Narrative Review on Ketamine’s Antisuicidal Actions

  • Aiste Lengvenyte
  • Emilie Olié
  • Philippe CourtetEmail author
Mood Disorders (E Baca-Garcia, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Mood Disorders

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.

Summary

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.

Keywords

Ketamine Suicide Suicidal ideation Neuronal plasticity Inflammation Anhedonia 

Notes

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.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Aiste Lengvenyte
    • 1
    • 2
  • Emilie Olié
    • 1
    • 3
  • Philippe Courtet
    • 1
    • 3
    Email author
  1. 1.Department of Psychiatric Emergency & Acute CareLapeyronie Hospital, CHU MontpellierMontpellierFrance
  2. 2.Faculty of Medicine, Institute of Clinical Medicine, Psychiatric ClinicVilnius UniversityVilniusLithuania
  3. 3.Neuropsychiatry, Epidemiological and Clinical Research, INSERMUniversity of MontpellierMontpellierFrance

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