When confronted with a suicidal patient, doctors could turn to a substance with uses that range from psychedelic party drug to animal anesthetic.
It’s called ketamine, a class III scheduled drug known for its similarities to PCP and its ability to induce dissociative and hallucinogenic feelings. The drug is the most commonly used among veterinarians for anesthetic purposes, according to Medical News Today, but is often illegally used in clubs and as a date-rape drug.
And now a study published in The American Journal of Psychiatry suggests the powerful drug could also help treat suicidal people.
Scientists conducted their study on 80 depressed adults with a score higher than four on the Scale for Suicidal Ideation, which doctors use to measure the scope and severity of a person’s intentions for self-harm. They gave some subjects ketamine, while others received midazolam, another anesthetic.
Just over 50 percent of the subjects were taking medications to treat depression, the study says.
Fifty-five percent of the subjects who took ketamine, also referred to as “Special K,” had a reduction in suicidal thoughts after the first day, the study found, while 30 percent of those who took midazolam had the same results. Researchers noted that some who took ketamine had a positive reduction in suicidal thoughts for up to six weeks and that any side effects from the drug such as increased blood pressure didn’t last long.
What’s more, the study found that ketamine directly contributed to a 33 percent of the reduction in patients’ SSI scores when researchers accounted for other factors.
Dr. Michael Grunebaum, an author of the study, said more research is needed into how ketamine could combat suicidal thoughts.
If the findings can be replicated, Grunebaum told Medical News Today, it could have big implications for health-care providers and those struggling with depression.
“Additional research to evaluate ketamine’s antidepressant and anti-suicidal effects may pave the way for the development of new antidepressant medications that are faster-acting,” he said, “and have the potential to help individuals who do not respond to currently available treatments.”
Not everyone is optimistic about the potential of the drug in depression treatment.
In a column for Psychology Today, Drs. Eugene Rubin and Charles Zorumski wrote that “our opinion is an emphatic ‘no’” when it comes to the question of whether ketamine can help protect suicidal patients.
They wrote that while ketamine is promising for those with depression, there is no way to predict how people struggling with other mental health issues like borderline personality disorder will react to the drug, or how those with substance abuse issues will respond.
That means more research – and oversight — is needed, they argued.
“Although administering ketamine in the emergency room might lower suicidal ideations and decrease depressive symptoms,” they wrote for Psychology Today, “would it be safe to discharge such an individual without observing them on a psychiatric inpatient unit first and seeing how they do over several days?”
Another study, this one from researchers at the Black Dog Institute in Australia, wanted to see whether ketamine delivered through a nasal spray could prove long-term treatment for those with depression.
It didn’t work out that well, the study says.
Like the other study, subjects were either given ketamine or midazolam and told to put 10 sprays into their nose. But those who took ketamine lost motor control and had trouble finishing the dose without help from researchers, the study says, while others had an increase in blood pressure.
“Intranasal ketamine delivery is very potent as it bypasses metabolic pathways, and ketamine is rapidly absorbed into the bloodstream,” said professor Colleen Loo. “But as our findings show, this can lead to problems with high peak levels of ketamine in some people causing problematic side effects Other recent studies have questioned whether changes to ketamine’s composition after being metabolised into derivative compounds may actually deliver useful therapeutic effects.
“It remains unclear,” she continued, “whether ketamine nasal sprays can be safely relied upon as a treatment for patients with severe depression.”