Pairing Ketamine With Opioid Treatment Extended Relief From Suicidal Thoughts
Stanford Medicine researchers found that combining a single ketamine infusion with a four-week low-dose buprenorphine regimen significantly prolonged relief from suicidal ideation in patients with major depressive disorder, with 78% of treated patients showing sustained improvement versus 48% on placebo. The study, published in the *American Journal of Psychiatry*, marks the first pharmacological method to extend ketamine’s antisuicidal effects beyond a week, offering a potential bridge to longer-term therapies like antidepressants or therapy.
Stanford Medicine researchers have identified a way to extend the antisuicidal effects of ketamine for at least a month by pairing it with low-dose buprenorphine. In a clinical trial involving 45 patients with major depressive disorder and suicidal ideation, participants received a single ketamine infusion followed by either daily low-dose buprenorphine or a placebo for four weeks. Those on buprenorphine showed greater and more lasting reductions in suicidal thoughts, with 78% remaining responsive to treatment compared to 48% in the placebo group. The study, published May 18 in the *American Journal of Psychiatry*, found that patients who received buprenorphine after ketamine had an average suicide ideation score of 3.6 after one month, well below the clinically significant threshold of 6. In contrast, those on placebo averaged 8.7, still above the threshold. Initially, patients scored an average of 15 on a 38-point scale, indicating moderate severity. Ketamine, a surgical anesthetic, rapidly reduces suicidal ideation but typically lasts only about a week. Buprenorphine, used for pain management and opioid use disorder treatment, extended this effect without affecting ketamine’s antidepressant benefits. Researchers suggest this combination could provide time for patients to explore other therapies, such as antidepressants or therapy, which take weeks to become effective. The study allowed participants to continue other medications, but further research is needed to assess long-term effects, repeated treatments, and efficacy in other depressive disorders like bipolar disorder. Lead authors Jason Tucciarone and Igor Bandeira emphasized the urgent need for treatments specifically targeting suicidality, as existing antidepressants often fail to address it adequately. This approach could offer hope for patients suffering from chronic suicidal ideation, offering a temporary but critical reprieve while they seek additional support.
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