Ketamine & Crisis Response Plan for Suicidal Ideation in the ED

Launched by THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO · Jan 12, 2023

Keywords

ClinConnect Summary

This clinical trial is studying the effectiveness of a combination treatment for adults who are experiencing suicidal thoughts when they visit the Emergency Department (ED). The treatment includes a one-time injection of 100mg of ketamine, a medication that may help improve mood, along with a short therapy session called a Crisis Response Plan, which usually takes about 30 minutes. The goal is to see if this combined approach can reduce suicidal thoughts more effectively than either treatment alone.

To participate in the trial, you need to be an adult between the ages of 18 and 70 who is facing acute suicidal thoughts and has been cleared for admission to a psychiatric unit. However, there are certain conditions that may prevent someone from joining, such as serious mental health issues, being under the influence of drugs, or having certain medical conditions. If you are eligible and choose to participate, you will receive the ketamine injection and the therapy session during your visit to the ED, both provided only once, to help you with your immediate needs.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adult men and women between the ages of 18 and 70 presenting to the Emergency Department with acute suicidal ideation.
• • Patient cleared for admission to the University Hospital inpatient psychiatric unit.
• • Decision to admit the patient to the inpatient unit or psychiatric stabilization unit made prior to consent to prevent study procedures from complicating or influencing the disposition and treatment as usual for suicidal patients reporting to the ED.
• • Individuals presenting to the ED for other complaints but found to have suicidal ideation necessitating admission will also be eligible.
• • Able to read and write English.
• Exclusion Criteria:
• • Serious mental illness with active and significant signs of psychosis, mania, hallucinations, paranoia, agitation, and drug-induced or other toxidromic symptoms.
• • Acute intoxication with clinically significant symptoms (as defined by the attending clinician's assessment of patients' clinical sobriety).
• • The patient is not capable of understanding the research procedures and providing informed consent for themselves.
• • Lack of reliable means to be available for follow-up assessments (e.g, working mobile phone).
• • Persistent resting blood pressure lower than 90/60 or higher than 180/110, or persistent resting heart rate lower than 45 beats/minute or higher than 120 beats/minute.
• • Injuries requiring procedural sedation.
• • Pregnancy or breast feeding.
• • Known hypersensitivity to ketamine.
• • Legal or illegal use of ketamine in the previous 90 days.
• • End-stage or severe cardiovascular (e.g., ACS or decompensated heart failure), liver, or kidney disease.
• • Patient is a prisoner.
• • Patient is physically restrained or actively under custody of law enforcement. Once a patient is no longer under custody of law enforcement or physically restrained, the patient may be considered eligible and may consent to voluntary enrollment in the study.