Feasibility and Safety of Ketamine for Suicidal Patients in the Emergency Department

Launched by LINDSAY MAGUIRE, MD · Oct 10, 2023

Keywords

ClinConnect Summary

This clinical trial is exploring the safety and effectiveness of low-dose intravenous ketamine for patients who come to the Emergency Department (ED) with thoughts of suicide. Ketamine is a medication that has been used successfully in treating severe depression that hasn’t responded to other treatments. The researchers want to see if it can also help people experiencing suicidal thoughts, which is a serious situation that needs immediate attention.

To participate in this study, applicants must be between 18 and 65 years old and must be experiencing acute suicidal thoughts, as determined by a specific assessment. Participants will need to be admitted for psychiatric care at the University of Kansas Medical Center. However, those with certain conditions, such as a history of severe mental illness, recent drug or alcohol use, or specific medical issues, will not be eligible. If you qualify and choose to participate, you can expect to receive ketamine under close medical supervision, and the team will monitor your response to the treatment. This study is important because it aims to find new ways to help people in crisis when no other options are available.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Acutely Suicidality ("yes" answer to any of items 4 or 5 on C-SSRS "Suicidal Ideation" category)
• • Require inpatient stabilization for SI or actions based on clinical observation and interview
• • Are accepted for psychiatric stabilization at the University of Kansas Medical Center's Strawberry Hill campus
• • Have a Glasgow Coma Score (GCS) of 15
• • Age 18-65
• Exclusion Criteria:
• • Current or past history of psychosis
• • Current or recent (past 4 weeks) symptoms of mania/hypomania as defined by Young Mania Rating Scale (YRMS) score of 12 or greater
• • History of ketamine use disorder
• • History of liver transplant
• • Pregnancy or breastfeeding
• • Imprisonment or inability to consent
• • Positive urine drug screen or serum alcohol level
• • Hypertension (SBP \> 160 or DBP \> 100 before administration of ketamine)
• • Hypotension (SBP \< 90)
• • Presence of acute medical condition requiring admission to medical service
• • Allergy, intolerance, or previous adverse reaction to ketamine
• • Patient has 8+ lifetime ketamine exposures
• • The treating physician determines that the patient is not a good candidate for the study (e.g. medical condition/procedure, medication that would contradindicate ketamine treatment)