Intravenous ketamine may find a place in the management of persons with suicidal ideation. But, randomized, controlled trials with larger numbers of participants are needed before firm conclusions can be drawn.
We may speculate whether ketamine’s ability to reduce suicidal ideation rapidly may allow some patients to avoid the need for hospitalization. But many questions remain.
1. A key question in this regard is whether the patients’ suicidal ideation could return in the next few days. If so, this may pose significant risks to the patient.
2. The risks of potential neurotoxicity or abuse with longer-term, repeated administration of ketamine will need to studied before its use can be recommended for clinical practice.
3. As the authors pointed out, suicidal ideation is a complex phenomenon involving both psychological and biological factors. So, ketamine may not be effective or appropriate for all persons with suicidal ideation.
Despite these limitations, this research raises the hope that in the future, similar rapid-acting anti-suicidal medications may be developed.