Understanding and Treating Suicidal Ideation With Ketamine

Launched by THE ROYAL'S INSTITUTE OF MENTAL HEALTH RESEARCH · Mar 18, 2025

Keywords

ClinConnect Summary

This clinical trial is exploring how effective ketamine, a medication often used for anesthesia, can be in treating people who are experiencing suicidal thoughts due to Major Depressive Disorder (MDD). The researchers want to find out if ketamine can significantly reduce these thoughts and if any changes in brain activity can be seen through MRI scans. Participants will receive four ketamine infusions through an IV over two weeks and will have MRI scans before and after the treatment to measure their mental health.

To join the study, participants need to be between 18 and 65 years old, speak English, and have a certain level of suicidal thoughts as measured by a specific scale. They should also have a diagnosis of MDD and be willing to stick to their current medications throughout the trial. Participants will be closely monitored, and their mood will be assessed before each MRI scan as well as through interviews after their treatment. It’s important to note that individuals with certain health conditions, recent substance use issues, or who are pregnant or breastfeeding may not be eligible. This study is currently looking for participants, so it could be an opportunity for those who meet the criteria and are seeking help.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. English speaking
• • 2. Ages 18-65 years old
• • 3. Suicidal ideation severity score ≥3 on the Columbia Suicide Severity Rating Scale (C-SSRS) (Baseline/Screening version) at Screening Visit ("active suicidal ideation with any methods")
• • 4. Diagnosis of Major Depressive Disorder (MDD) according to the Diagnostic and Statistical Manual for Mental Disorders 5th Edition (DSM-5)
• • 5. Willing to maintain stable doses of concomitant medications throughout the study
• • 6. Be under the care of a designated health care provider (i.e., family physician or psychiatrist) to follow their care after the completion of the study.
• Exclusion Criteria:
• • 1. Participants not medically cleared to receive ketamine treatment due to presence of clinically relevant disease (e.g., uncontrolled hypertension, renal or hepatic impairment, significant coronary artery disease, diabetes mellitus, seizure disorder).
• • 2. Known or suspected hypersensitivity or intolerance to ketamine
• • 3. Body mass index (BMI) ≥35
• • 4. History of a primary psychotic disorder (e.g., schizophrenia), or current or recent (\<2 years) acute episode of psychosis
• • 5. Current and/or recent history (\<12 months) of substance use/dependence (except for caffeine or nicotine) or problematic current alcohol use or dependence as defined by DSM-5 criteria
• • 6. Pregnant, breastfeeding or of childbearing potential and unwilling to use an approved method of contraception during the study
• • 7. History of significant head injury including loss of consciousness \>5 minutes
• • 8. Any MRI contraindications
• • 9. Concurrent use of ketamine in any form
• • 10. Concurrent active ECT or repetitive transcranial magnetic stimulation (rTMS) therapy