The Chemistry of Hope: Ketamine as a Turning Point in a Self-Harm Crisis

Abstract

Intentional Self-Harm (ISH) is a significant public health concern, especially in young adults, and is frequently associated with depressive disorders.^[1] While medical stabilization is the first priority, timely Psychiatric care is critical for prevention of recurrence. Low-dose Ketamine has recently been reported to produce rapid antidepressant effects, including reduction of suicidal ideation. ^[2] This report is of an old case of Moderate Depressive Episode, presenting after ingesting approximately 30 tablets of Clonazepam following a familial conflict. After initial emergency medical care, persistent suicidal thoughts led to initiation of eight-sessions of intravenous Ketamine treatment protocol. Within 24 hours, suicidal ideation reduced significantly.  Ongoing treatment and psychotherapy were continued and there was a sustained improvement at six-week follow-up. Ketamine may be a useful rapid acting adjunct for rapid reduction of suicidal ideation in treatment resistant depression, offering a bridge to ongoing treatment.