New Strategy Extends and Enhanced Ketamine's Treatment for Suicidal Feelings

What is it about?

Suicidal thoughts are a serious and poorly treated symptom of depression as there are currently no FDA-approved medications specifically targeting them. The anesthetic drug ketamine can rapidly quiet suicidal thinking, often within hours, but the relief typically fades within a week. Researchers at Stanford tested whether adding a second drug, buprenorphine that is best known for treating opioid addiction and pain, could make that relief last longer. In a trial of 50 patients with depression and suicidal ideation, everyone received a ketamine infusion and then took either low-dose buprenorphine or a placebo daily for four weeks. The results were striking: nearly four out of five patients on buprenorphine still had meaningful reductions in suicidal thinking at the end of the month, compared to fewer than half of those on placebo. Importantly, both drugs are already approved and available, meaning this combination could potentially reach patients without waiting years for new drug development. The study is small and more research is needed, but it represents the first pharmacological approach shown to extend ketamine's antisuicidal effects thus offering a window of relief long enough for other treatments, like conventional antidepressants or therapy, to take hold.

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Why is it important?

Suicide remains one of the leading causes of death worldwide, yet until now there are few medications specifically proven to reduce suicidal thinking. This drug combination can rapidly and durably target suicidality as a symptom in its own right, rather than hoping it resolves as a side effect of treating depression.