Initiating Ketamine in Acutely Suicidal Patients in the Emergency Department

About This Study

Current treatment for acutely suicidal patients are limited to hospitalization, psychotherapy, electro-convulsant therapy, or a combination of the aforementioned. However, this has added to the national boarding problem. Long term pharmacologic treatment for suicidal behaviors and mood stabilization has been studied in specific populations. In these populations, the decreases in suicidal ideation results from stabilization of the underlying psychiatric illness. Ketamine is most commonly used as an anesthetic with analgesic properties. It has been used off-label for pain management, procedural sedation, status epilepticus, and treatment resistant depression. It has been safely administered intravenously and well tolerated for chronic Post Traumatic Stress Disorder. It increases norepinephrine, dopamine, and serotonin through adrenergic neuron stimulation and prevention of catecholamine uptake. There is a strong corollary between stress and the development of depression and suicidal behaviors. It is proposed that the use of low dose intravenous ketamine may have benefit on the suicidal ideation of patients presenting to the Emergency Department.

Conditions Studied

Interventions

• •Ketamine Hydrochloride
• •Normal saline

Eligibility

Subject Inclusion and Selection Criteria

1. Patient demographics will consist of Active, Reserve, or retired military personnel or their dependents.

   Subjects must meet the following inclusion criteria:
2. Adult (18 to 89 years old)
3. Present with active SI
4. Deemed to being admitted to inpatient psychiatric unit

Subject Exclusion Criteria:

1. Age \< 18 years old or \> 89 years old
2. Currently presenting with psychosis as determined by mental health consultant
3. Have a history of Cognitive disorder that would impair understanding of consent
4. Have a personal/family history of Schizophrenia
5. Currently pregnant or nursing
6. Serious and unstable medical condition/problems
7. Inability to medically clear
8. Non-English Speakers
9. Civilian Humanitarians
10. Have previously enrolled in this study

Study Locations (1)