Rapid‐acting treatments for suicidal thoughts are critically needed. Consequently, there is a burgeoning literature exploring psychotherapeutic, pharmacologic, or device‐based brief interventions for suicidal thoughts characterized by a rapid onset of action. Not only do these innovative treatments have potentially important clinical benefits to patient populations, they also highlight a number of methodological considerations for suicide research. First, while most clinical trials related to suicide risk focus on suicide attempts, new clinical trials that use suicidal thoughts as the primary outcome require a number of slight modifications to their clinical trial design. Second, the rapid onset of these new interventions permits an experimental therapeutics approach to suicide research, in which psychological and neurobiological markers are embedded into clinical trials to better understand the underlying pathophysiology of suicidal thoughts. The following review discusses these methodological innovations in light of recent research using the N‐methyl‐D‐aspartate (NMDA) receptor antagonist ketamine, which has been associated with rapid effects on suicidal thoughts. We hope that “lessons learned” from the ketamine literature will provide a blueprint for all researchers evaluating rapid‐acting treatments for suicidal thoughts, whether pharmacologic or psychotherapeutic.

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快速改变自杀意念的临床试验：氯胺酮的教训

迫切需要对自杀念头进行快速治疗。因此，有大量文献探索心理治疗、药理学或基于设备的对自杀念头的简短干预，其特点是迅速采取行动。这些创新疗法不仅对患者群体具有潜在的重要临床益处，而且还突出了自杀研究的一些方法学考虑。首先，虽然大多数与自杀风险相关的临床试验都集中在自杀企图上，但以自杀念头为主要结果的新临床试验需要对其临床试验设计进行一些轻微修改。其次，这些新干预措施的迅速出现允许对自杀研究采用实验性治疗方法，其中心理和神经生物学标记被嵌入到临床试验中，以更好地了解自杀念头的潜在病理生理学。以下综述根据最近使用 N-甲基-D-天冬氨酸 (NMDA) 受体拮抗剂氯胺酮的研究讨论了这些方法创新，氯胺酮与对自杀念头的快速影响有关。我们希望从氯胺酮文献中吸取的“经验教训”将为所有研究人员提供一个蓝图，以评估针对自杀念头的快速治疗，无论是药物治疗还是心理治疗。这与对自杀念头的快速影响有关。我们希望从氯胺酮文献中吸取的“经验教训”将为所有研究人员提供一个蓝图，以评估针对自杀念头的快速治疗，无论是药物治疗还是心理治疗。这与对自杀念头的快速影响有关。我们希望从氯胺酮文献中吸取的“经验教训”将为所有研究人员提供一个蓝图，以评估针对自杀念头的快速治疗，无论是药物治疗还是心理治疗。