The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department Patients
Introduction: Suicidal ideation is an emergent problem in the Emergency Department (ED) that often complicates patient disposition and discharge. It has been shown that ketamine possesses fast acting antidepressant and anti-suicidal effects. This study was conducted to examine the effects of a singl...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2018-11-01
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| Series: | Archives of Academic Emergency Medicine |
| Subjects: | |
| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/20 |
| _version_ | 1818271666184126464 |
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| author | Parvin Kashani Shiva Yousefian Afshin Amini Kamran Heidari Somaie Younesian Hamid Reza Hatamabadi |
| author_facet | Parvin Kashani Shiva Yousefian Afshin Amini Kamran Heidari Somaie Younesian Hamid Reza Hatamabadi |
| author_sort | Parvin Kashani |
| collection | DOAJ |
| description | Introduction: Suicidal ideation is an emergent problem in the Emergency Department (ED) that often complicates patient disposition and discharge. It has been shown that ketamine possesses fast acting antidepressant and anti-suicidal effects. This study was conducted to examine the effects of a single intravenous bolus of ketamine on patients with suicidal ideations in ED. Methods: Forty-nine subjects with suicidal ideations with or without an unsuccessful suicide attempt, received 0.2 mg/kg of ketamine. Scale for suicidal ideation (SSI) and Montgomery-Abserg depression-rating scale (MADRS) were evaluated before and 40, 80 and 120 minutes after drug intervention. The results were compared using the paired t-test and patients were followed up 10 days after ED admission for remnant suicide ideation. Results: SSI (df: 3, 46; F=80.7; p<0.001) and MADRS (df: 3, 46; F=87.2; p<0.001) scores significantly dropped after ketamine injection; the SSI score before and after 20, 40, and 80 minutes of ketamine injection were 23.0±6.7, 16.2±5.2, 14.3±4.3, and 13.6±4.0 respectively. The MADRS scores were 38.2±9.3, 25.6±7.1, 22.7±6.3, and 22.1±5.95 at the same time intervals. 25.5% of patients were hospitalized, 63.3% received medications and 12.2% discharged. 6.2% of patients had suicidal ideations ten days after ED disposition.  Conclusion: It seems that Ketamine could not be a good choice for fast reduction of suicidal ideations in ED patients. Further studies are needed to determine the optimal dose of ketamine for different patients. |
| first_indexed | 2024-12-12T21:29:48Z |
| format | Article |
| id | doaj.art-a84e84d76a584c19ac26ec0d6434b6d2 |
| institution | Directory Open Access Journal |
| issn | 2645-4904 |
| language | English |
| last_indexed | 2024-12-12T21:29:48Z |
| publishDate | 2018-11-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj.art-a84e84d76a584c19ac26ec0d6434b6d22022-12-22T00:11:21ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042018-11-012110.22037/aaem.v2i1.20The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department PatientsParvin Kashani0Shiva Yousefian1Afshin Amini2Kamran Heidari3Somaie Younesian4Hamid Reza Hatamabadi5Department of Emergency, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Emergency, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Emergency, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Emergency, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Emergency, Shahid Beheshti University of Medical Sciences, Tehran, Iran1. Department of Emergency, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2. Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranIntroduction: Suicidal ideation is an emergent problem in the Emergency Department (ED) that often complicates patient disposition and discharge. It has been shown that ketamine possesses fast acting antidepressant and anti-suicidal effects. This study was conducted to examine the effects of a single intravenous bolus of ketamine on patients with suicidal ideations in ED. Methods: Forty-nine subjects with suicidal ideations with or without an unsuccessful suicide attempt, received 0.2 mg/kg of ketamine. Scale for suicidal ideation (SSI) and Montgomery-Abserg depression-rating scale (MADRS) were evaluated before and 40, 80 and 120 minutes after drug intervention. The results were compared using the paired t-test and patients were followed up 10 days after ED admission for remnant suicide ideation. Results: SSI (df: 3, 46; F=80.7; p<0.001) and MADRS (df: 3, 46; F=87.2; p<0.001) scores significantly dropped after ketamine injection; the SSI score before and after 20, 40, and 80 minutes of ketamine injection were 23.0±6.7, 16.2±5.2, 14.3±4.3, and 13.6±4.0 respectively. The MADRS scores were 38.2±9.3, 25.6±7.1, 22.7±6.3, and 22.1±5.95 at the same time intervals. 25.5% of patients were hospitalized, 63.3% received medications and 12.2% discharged. 6.2% of patients had suicidal ideations ten days after ED disposition.  Conclusion: It seems that Ketamine could not be a good choice for fast reduction of suicidal ideations in ED patients. Further studies are needed to determine the optimal dose of ketamine for different patients.https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/20Ketaminesuicidesuicidal ideationemergency |
| spellingShingle | Parvin Kashani Shiva Yousefian Afshin Amini Kamran Heidari Somaie Younesian Hamid Reza Hatamabadi The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department Patients Archives of Academic Emergency Medicine Ketamine suicide suicidal ideation emergency |
| title | The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department Patients |
| title_full | The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department Patients |
| title_fullStr | The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department Patients |
| title_full_unstemmed | The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department Patients |
| title_short | The Effect of Intravenous Ketamine in Suicidal Ideation of Emergency Department Patients |
| title_sort | effect of intravenous ketamine in suicidal ideation of emergency department patients |
| topic | Ketamine suicide suicidal ideation emergency |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/20 |
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