Open-label trial · 2025
Pilot study of a single nasal ketamine dose for acute suicidal thoughts in 12 patients
- Original title
- Single fixed-dose intranasal racemic ketamine treatment for the treatment of acute suicidality in a transdiagnostic patient population: Results of a pilot study.
- Authors
- Roelandt GHJ, Strous JFM, Marijnissen RM, et al.
- Journal
- Psychiatry research, 2025
- Molecules
- Ketamine
- Conditions
- Suicidal ideation, Depression
- Participants
- 12
- Evidence grade
- Very low
- Source
- Read the original paper
The question
Is a single fixed dose of nasal spray ketamine feasible, acceptable and safe for people arriving at emergency care with acute suicidal thoughts, whatever their underlying diagnosis?
What they did
Between September 2021 and June 2022, researchers recruited 12 patients experiencing acute suicidality. Everyone knew they were getting the drug: a single 75 mg dose of generic intranasal racemic ketamine, with no placebo comparison. Suicidal thinking, depression, side effects and overall clinical improvement were measured at 60 and 180 minutes and at 1, 3 and 7 days afterwards, with vital signs watched for the first 240 minutes. Optional blood samples and a brain scan one day later were also offered.
What they found
The treatment was generally well tolerated. Scores for suicidal thinking (Beck Scale for Suicidal Ideation) and for depression (Montgomery-Asberg Depression Rating Scale) showed a downward trend one day after treatment, but this trend had faded by day seven. The abstract reports no specific score numbers. One of the 12 patients went on to develop ketamine misuse several weeks after taking part in the study.
The fine print
This was a small pilot with just 12 people, no placebo group and no blinding, so any improvement could reflect natural recovery, ongoing care or expectation. Follow-up was only seven days, and the abstract gives trends rather than actual numbers or statistical tests. One case of later ketamine misuse in such a small group is a notable safety signal. This summary is based on the abstract alone.
What it means
Giving a single nasal dose of ketamine to acutely suicidal patients appeared feasible and was tolerated, but this study was designed to test practicality rather than whether it works, and any benefit seen was short-lived.
Evidence grade: Very low. A single-arm, open-label pilot in only 12 people with no placebo group, so no reliable conclusions about effectiveness can be drawn.
This summary is based on the study’s published abstract.