Date of Award

2-2026

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not a “single dose of intravenous (IV) ketamine can decrease suicidal ideation in adults with major depressive disorder (MDD)?”

STUDY DESIGN: A systematic review of 3 double-blind, randomized controlled trials (RCTs) published from 2018 to 2024.

DATA SOURCES: All RCTs were found using PubMed and Google Scholar. The articles were published in peer-reviewed journals and in English. The articles were selected based on their relevance to the clinical question posed in the objective.

OUTCOMES MEASURED: All 3 studies focused on reducing suicidal ideation. The outcome was measured using either Beck’s Suicidal Ideation Scale (BSIS) or the Scale of Suicidal Ideation (SSI). Both range from 0 to 38.

RESULTS: The studies showed that IV ketamine is an effective treatment in rapidly reducing suicidal ideation in adults with MDD. Zolghadriha et al. found no significant difference in BSIS scores between the IV ketamine and control groups before intervention (6.74 ± 6.67 vs 3.58 ± 2.57; p = 0.11), but after treatment, the IV ketamine group demonstrated a significantly greater reduction in BSIS scores compared with controls (0.42 ± 1.52 vs 3.35 ± 2.80; mean difference= -2.93; p < 0.001). Grunebaum et al. reported that at day 1 post-infusion, ketamine produced a significantly greater reduction in SSI scores compared with midazolam (6.20 vs 11.16), with a mean difference of 4.96 (95% CI 2.33–7.59; p < 0.001). Moayedi et al. demonstrated comparable baseline SSI scores between groups, but at 24 hours post-infusion, patients receiving IV ketamine showed a significant decrease in SSI scores (from 17.53 ± 10.17 to 2.53 ± 4.92), while control scores increased (from 19.93 ± 6.08 to 20.60 ± 5.35) (p < 0.001).

CONCLUSIONS: Each RCT showed statistically significant improvement in suicidal ideation after receiving a single dose of IV ketamine. The results of this systematic review are conclusive and suggest that IV ketamine rapidly reduces suicidal ideation in adults with MDD. Further studies are needed to clarify the duration of benefit and long-term clinical outcomes associated with IV ketamine use.

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