B.C. Children’s Hospital Research Institute is conducting the study. Senior executive Dr. Quynh Doan said the study aims to find a faster and safer way to help youth in need before they reach the emergency room. When children come to the ER after attempting suicide, there is currently no standardized treatment. “We see them and assess their safety risk,” Doan said.
At subanesthetic doses, ketamine is a vital tool in treating depression and suicidal thoughts. Part of what makes it so unique is how quickly it works. As a 2020 study suggests, traditional antidepressants improve symptoms in about an extra 20 out of 100 people. Even for those who do respond, these antidepressants can take weeks to take effect. If someone is suicidal, they often don’t have this much time to sit around and see if such antidepressants work. There’s also a decent probability that if one is in the hospital for suicidal thoughts, they’ve already tried traditional medications, which haven’t worked.
Ketamine treatment can show results within hours to days after administration and shows unique promise for those experiencing suicidal thoughts. Although most of this research comes from using off-label intravenous infusions, in 2019, a nasal spray called Spravato (esketamine) was approved for use by the Food and Drug Administration (FDA) for treatment-resistant depression. A 2019 study gave patients with treatment-resistant depression received six infusions over the course of two weeks. They saw a notable improvement after the first dose, which continued to be effective in the month following. Typically, folks who receive ketamine infusions for depression or suicidal thoughts first go in for the initial six rounds. Then, they return for boosters as needed, from weekly to every few months.
And now, thanks to B.C. Children’s Hospital Research Institute, teenagers and youth may have a chance to experience such results. Suicide is the second-leading cause of death for people between 15 to 24 in the U.S., and almost 20% of high school students report severe thoughts of suicide. Nine percent have attempted to take their lives, according to the National Alliance on Mental Illness.
“If we find that this works and is safe, we could give ketamine to kids who are distressed with acute suicidal thoughts in the emergency department, get them feeling better while resources can be put in place and the psychotherapy or the antidepressants start working,” Doan said in a statement. This would allow the patients to recover in the comfort of their families. “If we can set up a safety plan at home, then the young person goes home and their family watches them like a hawk for the next few days and weeks,” Doan said.
The study (there is currently a similar one happening in San Diego) includes kids between the ages of ten to 16 with suicidal urges. They aim to have 96 patients for the pilot. Each patient will get one of three options: a low dose of ketamine, a placebo, or another kind of sedative. They will then be monitored over the next hours to weeks.
B.C. Children’s Hospital Research Institute plans to measure the recovery of the patients using three different scales. Whichever is most effective will be implemented on a larger version of the study. Doan aims to conduct the following research at 11 locations across Canada to collect even more data on this potentially life-saving treatment. “If using ketamine works for children and youth with suicidal ideation, it’s going to dramatically improve how we take care of these kids,” Doan said. “It will change the experience of youth and families dealing with this challenging condition.”
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