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REPLY

Acute Effects of Intravenous Sub-Anesthetic Doses of Ketamine and Intranasal Inhaled Esketamine on Suicidal Ideation: A Systematic Review and Meta-Analysis: Letter in Response [Response to Letter]

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Pages 1623-1624 | Received 05 Jul 2023, Accepted 11 Jul 2023, Published online: 17 Jul 2023
This article responds to:
Acute Effects of Intravenous Sub-Anesthetic Doses of Ketamine and Intranasal Inhaled Esketamine on Suicidal Ideation: A Systematic Review and Meta-Analysis: Letter in Response [Letter]

Dear editor

Thank you very much for your attention and advice, as this is indeed a thought-provoking issue. Although the US Food and Drug Administration (FDA) has not yet recognized the advantages of ketamine in treating depression and preventing suicide, relevant research results show that ketamine also has a significant role in preventing suicide.Citation1 In addition, the results of a randomized controlled trial also showed that in the treatment of depression, both ketamine and esketamine have therapeutic effects.Citation2

However, as you rightly pointed out, the adverse reactions related to ketamine have limited its widespread use in clinical applications, which may be the main reason why it has not been approved by the FDA. In contrast, as the only drug approved by the FDA, esketamine has better efficacy and safety. Therefore, we suggest considering the use of esketamine in future antidepressant or antisuicide intervention studies. If ketamine is used consistently, more careful consideration and strict ethical review are required.

We once again appreciate your interest in our research and value your valuable feedback.

Disclosure

The authors report no conflicts of interest in this communication.

References

  • Abbar M, Demattei C, El-Hage W, et al. Ketamine for the acute treatment of severe suicidal ideation: double blind, randomised placebo controlled trial. BMJ. 2022;376:e067194. doi:10.1136/bmj-2021-067194
  • Correia-Melo FS, Leal GC, Vieira F, et al. Efficacy and safety of adjunctive therapy using esketamine or racemic ketamine for adult treatment-resistant depression: a randomized, double-blind, non-inferiority study. J Affect Disord. 2020;264:527–534. doi:10.1016/j.jad.2019.11.086