Evidence map›Paper›PMID 29202655›Full record

Trial reportThe American journal of psychiatry2018

Ketamine for Rapid Reduction of Suicidal Thoughts in Major Depression: A Midazolam-Controlled Randomized Clinical Trial.

Michael F Grunebaum, Hanga C Galfalvy, Tse-Hwei Choo, John G Keilp, Vivek K Moitra, Michelle S Parris, Julia E Marver, Ainsley K Burke, Matthew S Milak, M Elizabeth Sublette and 2 more

2 registry-linked trialsOpen access · bronzeAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 187 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
187citing papers in PubMed, 20 pooled it
25.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04658420 phase2unknown statusnot on this mapstarted 2021, after this paper: background citation

A Single Ketamine Infusion Combined With Music for Suicidal Ideation During a Depressive Episode: A Randomized Open Label Clinical Trial

TypeinterventionalSponsorThe University of Texas Health Science Center at TylerRan2021 to 2023Enrolled200ConditionsSuicidal Ideation, Depressive EpisodeArmsKetamine Hydrochloride, Music
NCT06752759 phase3recruitingnot on this mapstarted 2024, after this paper: background citation

Nebulized Ketamine for the Treatment of Major Depressive Disorder in an Inpatient Setting: A Midazolam-controlled Randomized Controlled Trial

TypeinterventionalSponsorTheresa Jacob, PhD, MPHRan2024 to 2027Enrolled40ConditionsSevere Depression, Moderate Depression, Ketamine, MidazolamArmsnebulized ketamine, nebulized midazolam
3 · Its place in the literature

Who cites it

187 citing papers in PubMed, 20 syntheses or guidelines pooled it, 412 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Ketamine for Bipolar Depression: A Systematic Review.The international journal of neuropsychopharmacology · 2021
    Pooled it
  15. Pooled it
  16. Pooled it
  17. Pooled it
  18. Pooled it
  19. Pooled it
  20. Pooled it

127 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Michael F GrunebaumFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
Hanga C GalfalvyFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
Tse-Hwei ChooFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
John G KeilpFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
Vivek K MoitraFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
Michelle S ParrisFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
Julia E MarverFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
Ainsley K BurkeFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
Matthew S MilakFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
M Elizabeth SubletteFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
Maria A OquendoFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
J John MannFrom the Molecular Imaging and Neuropathology Division, Department of Psychiatry, and the Department of Anesthesiology, Columbia University Medical Center and New York State Psychiatric Institute, New York.
New York Psychoanalytic Society and Institute · US

Funding

Ketamine vs Midazolam: Testing Rapid Relief of Suicide Risk in DepressionR01MH096784 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI GRUNEBAUM, MICHAEL F · 2012 to 2016
$2.8M
NIMH NIH HHS R01 MH096784
6 · The paper itself

Abstract

objectivePharmacotherapy to rapidly relieve suicidal ideation in depression may reduce suicide risk. Rapid reduction in suicidal thoughts after ketamine treatment has mostly been studied in patients with low levels of suicidal ideation. The authors tested the acute effect of adjunctive subanesthetic intravenous ketamine on clinically significant suicidal ideation in patients with major depressive disorder.

methodIn a randomized clinical trial, adults (N=80) with current major depressive disorder and a score ≥4 on the Scale for Suicidal Ideation (SSI), of whom 54% (N=43) were taking antidepressant medication, were randomly assigned to receive ketamine or midazolam infusion. The primary outcome measure was SSI score 24 hours after infusion (at day 1).

resultsThe reduction in SSI score at day 1 was 4.96 points greater for the ketamine group compared with the midazolam group (95% CI=2.33, 7.59; Cohen's d=0.75). The proportion of responders (defined as having a reduction ≥50% in SSI score) at day 1 was 55% for the ketamine group and 30% for the midazolam group (odds ratio=2.85, 95% CI=1.14, 7.15; number needed to treat=4.0). Improvement in the Profile of Mood States depression subscale was greater at day 1 for the ketamine group compared with the midazolam group (estimate=7.65, 95% CI=1.36, 13.94), and this effect mediated 33.6% of ketamine's effect on SSI score. Side effects were short-lived, and clinical improvement was maintained for up to 6 weeks with additional optimized standard pharmacotherapy in an uncontrolled follow-up.

conclusionsAdjunctive ketamine demonstrated a greater reduction in clinically significant suicidal ideation in depressed patients within 24 hours compared with midazolam, partially independently of antidepressant effect.

Indexed as

Suicidal IdeationAdultBehavior Rating ScaleDouble-Blind MethodFemaleHumansInfusions, IntravenousKetamineMajor Depressive DisorderMaleMidazolamMiddle AgedSuicideSuicide PreventionYoung AdultKetamineMidazolamClinical TrialDepressionKetamineSuicidal Ideation

Identifiers

PMID29202655
PMCPMC5880701
OpenAlexW2771797851

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.