Time magazine has a cover story (August 7, 2017) titled:


Depression afflicts 16 million Americans.
One third don’t respond to treatment
A surprising new drug may change that”

The drug in question is ketamine. Will ketamine stop suicidal thoughts better than traditional antidepressants?

When someone is suicidal seconds count!

Q. Is ketamine infusion safe for the elderly? My son’s mother-in-law (age 69) has been diagnosed with major depression. She has made two suicide attempts.

I am not sure what she is taking now, but she seems apathetic, worries about everything and interacts inappropriately with family. She is almost completely unresponsive to her grandchildren. This is a total change from her personality five years ago, when she was devoted to her family and engaged with the world.

A. Major depression takes a terrible toll on the individual, family and friends. Suicide attempts are a clear signal that your son’s mother-in-law is desperate and requires expert medical intervention.

Ketamine (Ketalar) is a fascinating drug that has been used since 1962 as a general anesthetic. Over the last several years researchers have discovered that this medication has profound antidepressant activity that kicks in within hours instead of the usual weeks of standard drugs. When someone is suicidal it is dangerous to wait weeks for an antidepressant drug to work.

Will Ketamine Stop Suicidal Thoughts?

A recent meta-analysis found that ketamine is effective in reducing suicidal ideation within four hours (Neuroscience and Biobehavioral Reviews, June 2017).  Unfortunately, research has not yet shown how long this effect may last.

This isn’t the first assessment of ketamine in the treatment of suicidal thoughts.

Here are some other reports in the medical literature:

“Sublingual (under the tongue) Ketamine for Rapid Relief of Suicidal Ideation”:

“These cases demonstrate that low doses of sublingual ketamine repeated over a span of hours can induce rapid remission of suicidality in unipolar or bipolar depression.

“Chronic use of oral or sublingual ketamine has been helpful in the past 4 years for many of my patients with mild depressive symptoms.

“Sublingual ketamine may be a practical option for managing suicidality in outpatients as an adjunct to traditional antidepressants and mood stabilizers and could shorten the hospital stay of psychiatric inpatients. Sublingual ketamine is worthy of systematic study as a treatment to provide rapid relief of suicidal ideation.”

Reduction in Suicidal Ideation Following Repeated Doses of Intravenous Ketamine?

…”the evidence to date supporting the clinical use of ketamine as antisuicidal treatment is extremely preliminary, and on the basis of the article by Ionescu et al, conclusions concerning the effects of ketamine on suicidal ideation should be drawn with caution.”

Ketamine Rapidly Relieves Acute Suicidal Ideation in Cancer Patients: A Randomized Controlled Clinical Trial

“Cancer patients experience increased risk and incidence of suicide and other psychiatric disorders.

“In the past 10 years, evidence has emerged showing that sub-anesthetic doses of ketamine (0.5 mg/kg) induce fast-acting antidepressant effects on depressed patients. Antidepressant effects of ketamine were observed as soon as 40 min after infusion and typically lasted at most for 7 days, with some patients experiencing more prolonged mood improvement.

” Collectively, this study provides novel information about the rapid antidepressant effect of ketamine on acute depression and suicidal ideation in newly-diagnosed cancer patients.”

“Ketamine for Treatment of Suicidal Ideation and Reduction of Risk for Suicidal Behavior”

(in Current Psychiatry Reports, June, 2016).

“Our review concludes that ketamine treatment can be seen as a double-edged sword, clinically to help provide treatment for acutely suicidal patients and experimentally to explore the neurobiological nature of suicidal ideation and suicidal behavior.”

Ketamine and Your Mother-In-Law:

There is inadequate research on ketamine infusion in older patients (Expert Opinion on Pharmacotherapy, April 2017).  Since this medication may alter blood pressure and heart rate, the latest recommendations from the American Psychiatric Association call for monitoring so that immediate care may be provided if necessary (JAMA Psychiatry, April 1, 2017).

More articles from The People’s Pharmacy about whether Ketamine can stop suicidal thoughts are available at these links:

Can Ketamine Jump Start Antidepressant Action?

Radio Show # 983 (FREE): Intriguing Approaches to Overcoming Depression

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  1. Chaela

    Think the scientific method need be applied — where is the research?

  2. Michelle

    My son just had a ketamine infusion to treat pain and depression. He came out of the experience positive and claimed he had an outer body experience, where he met people who had died including Jesus (he is not religious).

    After sitting telling his father and I about how positive everything was, he then said he was incredibly tired and was going to bed. He went upstairs and overdosed! He is currently in hospital with no recollection of the event! He was not suisidal before the treatment. I need to understand what happened?

  3. Dr. Judith
    Kfar Saba, Israel

    WRT ketamine for the 69 year old mother-in-law, her changed behavior might be due to a neurological supratentorial problem. She needs a thorough neurological evaluation before we rush to assume it is depression.
    Symptoms are not diseases!
    and diagnosis should usually precede treatment.

  4. Kristine

    Oops, might have used text slang for by the way and gave a hardy God forbid. Sorry

  5. Kristine

    Bring on the ketamine!!! Antidepressants are benign based on my experience. If you have to take meds to be happy, wth are they waiting for? Seems docs or the agencies that hound them are scared to death that some people experience euphoria, which btw was listed as a negative side effect on a medicine I recently read about. GOD FORBID anyone feel euphoria. Omg, the backward way of thinking of the powers that be.

  6. Pamela

    I have personal experience with remarkable effects of Ketamine as after-effects of outpatient surgeries in which Ketamine was used. One chronic, post-infectious symptom disappeared permanently but chronic fatigue and neuromuscular symptoms were only helped short-term, but was transformational during that time. My mood was also incidentally brightened by the lifting of those symptoms.

    Ketamine has been studied most for depression and pain and found to be remarkably and rapidly effective for many – possibly 70% or more, and is considered extremely safe as used for those purposes in various forms. The only drawback I know of is cost, which is not covered by insurance generally, and travel costs if one does not live near a doctor that offers the therapy. It’s possible a local psychiatrist might prescribe the oral form on request.

    This resource website was started by people who had participated in Ketamine research trials. http://www.ketamineadvocacynetwork.org/

  7. Pam

    Having been diagnosed over 25 years ago with Clinical Depression, I have freedom of speech
    to say how awful depression is. Have been on 4 different medications for depression,
    two of which made me feel like a walking dead person emotionally, and two which worked
    great. They allowed me to feel like a functioning, pleasant, content mother & wife & volunteer.

    If Ketamine kicks in quickly, go for it & once on an emotionally-even keel, work with any side effects which may pop up. Don’t say “Oh, if only my mother ( or fill in the blank) had taken Ketamine, she would not be dead now.”

  8. Malcolm

    Sunshine throughout the summer and D3 supplements, 5-10,000 units a day, throught the winter when the sun is low and one is covered up is the best medicine. My daughter was Manic depressive from her teenage years and had suicidal thoughts at closer and closer intervals into her thirties when she started taking D3 as virus preventative and we all noticed that her ups and downs smoothed out and she lost the self destructive thoughts altogether, I suggested D3 and/or sunshine to a friend in Viet Nam who was anorexic/bulimic and manic depressive. She straightened out in a few weeks.

    Now, she makes a point of getting sunshine every day in that sunniest of countries. That is anecdotal, I suppose but I have seen it repeat a number of times and have become a missionary for sunshine.

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