BACKGROUND Depressed patients presenting to emergency departments with acute suicidal ideation are a major public health concern. Ketamine, a rapidly acting antidepressant with antisuicidal properties, might offer relief. METHODS In a randomized, double-blind, placebo-controlled, proof-of-concept trial, 18 depressed subjects with acute suicidal ideation, who required hospitalization, were randomized to either an intravenous ketamine 0.2 mg/kg group or a saline placebo group. Safety and efficacy evaluations were scheduled for 15, 30, 60, 90, 120, 180, and 240 min, and on Days 1, 2, 3, 7, and 14 after infusion. The main outcome measure was suicidal ideation with secondary measures of depression. RESULTS Nine subjects were randomized to each group. There were no differences between groups at baseline in any demographic or assessment scales. A reduction in suicidal ideation was noted at 90-180 min (p < .05). Ninety minutes after infusion, 88% of the ketamine group had achieved remission of suicidal ideation compared with 33% in the placebo group (p < .05). No serious adverse events were noted. CONCLUSIONS Ketamine was safe and effective for rapid reduction in suicidal ideation in depressed, highly suicidal subjects presenting to the emergency department. Our results support further study of ketamine for acute suicidal ideation.

中文翻译：

---

氯胺酮用于急性自杀意念。急诊科干预：一项随机、双盲、安慰剂对照、概念验证试验。

背景患有急性自杀意念的抑郁患者到急诊科就诊是一个主要的公共卫生问题。氯胺酮是一种具有抗自杀特性的快速起效抗抑郁药，可能会提供缓解。方法 在一项随机、双盲、安慰剂对照、概念验证试验中，18 名有急性自杀意念、需要住院治疗的抑郁受试者被随机分配到静脉注射氯胺酮 0.2 mg/kg 组或生理盐水安慰剂组。安全性和有效性评估计划在输注后 15、30、60、90、120、180 和 240 分钟以及第 1、2、3、7 和 14 天进行。主要结果测量是自杀意念和抑郁的次要测量。结果 九名受试者被随机分配到每组。在任何人口统计或评估量表中，基线组之间没有差异。在 90-180 分钟时发现自杀意念减少 (p < .05)。输注 90 分钟后，氯胺酮组 88% 的患者实现了自杀意念的缓解，而安慰剂组为 33% (p < .05)。没有注意到严重的不良事件。结论 氯胺酮对于在急诊科就诊的抑郁、高度自杀的受试者快速减少自杀意念是安全有效的。我们的结果支持进一步研究氯胺酮治疗急性自杀意念。向急诊科就诊的高度自杀性受试者。我们的结果支持进一步研究氯胺酮治疗急性自杀意念。向急诊科就诊的高度自杀性受试者。我们的结果支持进一步研究氯胺酮治疗急性自杀意念。