Study of IV Ketamine for Emergency Department Treatment of Adolescent Suicidal Ideation

Launched by CHILDREN'S HOSPITAL OF EASTERN ONTARIO · Apr 12, 2024

Keywords

ClinConnect Summary

This clinical trial is studying the use of intravenous (IV) ketamine as a rapid treatment for adolescents experiencing suicidal thoughts, a serious issue affecting many young people in Canada. The researchers want to see if ketamine, a medication already used safely in emergency situations, can quickly reduce these thoughts in teenagers aged 12 to 17. Currently, there are no fast-acting treatments available in emergency departments for this urgent medical situation, so this study could lead to significant improvements in how doctors help young patients in crisis.

To be eligible for the trial, participants must have moderate to severe suicidal thoughts and be medically clear to participate, meaning they don’t have serious physical injuries or other health issues that need immediate attention. Eligible teens will receive IV ketamine and be monitored closely to see how it affects their suicidal thoughts. If successful, this treatment could provide immediate relief for young people until they can receive longer-term mental health support. It’s an important step toward improving emergency care for adolescent mental health issues across Canada and potentially beyond.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Responds "yes" to Ask Suicide Screening Question (ASQ) #5 at triage, which asks; "Are you having thoughts of killing yourself right now?"
• • 2. Moderate to severe suicidal ideation, defined as score ≥ 3 on the first 5 questions of the Beck Scale for Suicidal Ideation (SSI5)
• • 3. Age 12 to 17 years, inclusive
• • 4. Medically clear (deemed fit for participation in the trial), as judged by the treating physician. Minimum criteria required to be deemed medically clear are: a) No evidence of serious physical injury requiring urgent intervention b) No evidence of acute ingestion requiring monitoring, blood tests, imaging or ECG or in the context of acute ingestion they have satisfied the requisite number of hours of post-ingestion monitoring with no further need for intervention.
• Exclusion Criteria:
• • 1. Acute intoxication from any substance, including alcohol
• • 2. Previously enrolled in the current study or currently enrolled in another clinical trial
• • 3. History of intellectual disability or autism spectrum disorder by patient/parent report
• • 4. Active, or history of, psychosis or psychotic disorder
• • 5. History of non-psychiatric neurologic disorder (e.g., epilepsy)
• • 6. Any of the following contraindications to ketamine based on the drug monograph: a) Known allergy or hypersensitivity to ketamine by patient history b) History of cerebrovascular accident (stroke or aneurysm) c) History of elevated intracranial pressure or idiopathic intracranial hypertension d) Significant hypertension requiring daily medication e) Severe cardiac decompensation
• • 7. On an involuntary psychiatric hold
• • 8. Requires physical or chemical restraint
• • 9. History of violence while in hospital
• • 10. Pregnant or breastfeeding
• • 11. Received opioids in the 2-hours prior to study screening