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The acute antisuicidal effects of single-dose intravenous ketamine and intranasal esketamine in individuals with major depression and bipolar disorders: A systematic review and meta-analysis.
Xiong, Jiaqi; Lipsitz, Orly; Chen-Li, David; Rosenblat, Joshua D; Rodrigues, Nelson B; Carvalho, Isabelle; Lui, Leanna M W; Gill, Hartej; Narsi, Flora; Mansur, Rodrigo B; Lee, Yena; McIntyre, Roger S.
Afiliação
  • Xiong J; Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada.
  • Lipsitz O; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • Chen-Li D; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • Rosenblat JD; Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • Rodrigues NB; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • Carvalho I; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • Lui LMW; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • Gill H; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
  • Narsi F; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • Mansur RB; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • Lee Y; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
  • McIntyre RS; Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, To
J Psychiatr Res ; 134: 57-68, 2021 02.
Article em En | MEDLINE | ID: mdl-33360864
The efficacy of ketamine in reducing suicidal ideation (SI) has been previously reported. We aimed to evaluate acute anti-SI effects of single-dose ketamine in different formulations/routes of administration by pooling results from randomized controlled trials (RCTs). A systematic search was conducted on Cochrane, Embase, Medline, and PubMed from inception to July 1st, 2020. Studies were selected based on pre-determined eligibility criteria. Effect sizes of different formulations/routes at various time points were computed using random-effects models. With data from nine eligible RCTs (n = 197), the pooled effect size for anti-SI effects at the 24-h time point was 1.035 (N = 6, CI: 0.793 to 1.277, p < 0.001) for intravenous (IV) racemic ketamine and 1.309 (N = 1, CI: 0.857 to 1.761, p < 0.001) for intranasal (IN) esketamine. An additional five RCTs were available for qualitative analysis. RCTs were identified for oral/sublingual ketamine for depression, however, none of these trials reported anti-SI effects preventing quantitative analysis for these routes of delivery. No RCTs for intramuscular (IM) ketamine were identified. The findings suggest that single-dose IV ketamine/IN esketamine is associated with robust reductions in suicidal thoughts at 2-h, 4-h, and 24-h post-intervention. In addition, future studies on IM/oral/sublingual ketamine and comparative studies are warranted to evaluate the anti-SI efficacy of distinct formulations and routes of administration.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtorno Bipolar / Transtorno Depressivo Maior / Ketamina Tipo de estudo: Clinical_trials / Prognostic_studies / Qualitative_research / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtorno Bipolar / Transtorno Depressivo Maior / Ketamina Tipo de estudo: Clinical_trials / Prognostic_studies / Qualitative_research / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article