“In patients with the presence of suicidal ideation and major depressive disorder, we suggest offering ketamine infusion as an adjunctive treatment for short-term reduction in suicidal ideation,” the guideline states.
The guideline addresses the rising rate of suicide among veterans. From 2005 to 2015, the veteran suicide rate increased by 25%. Twenty veterans commit suicide daily. And veterans have a 21% higher risk of suicide compared to peers of the same age and sex.
Post Traumatic Stress Disorder (PTSD) is a significant cause behind veteran suicide. According to the VA, PTSD affects roughly 31% of Vietnam veterans, 10% of Gulf War veterans, and 11% of the war in Afghanistan veterans. PTSD symptoms include anxiety and depression, guilt, shame, personality changes, and self-destructive behaviors. Many suffering from PTSD take their own lives.
Evidence Supports Ketamine's Effectiveness
The VA’s updated guidelines, and resulting ketamine recommendation, stem from a systematic review conducted by Dr. Kristen D’Anci of the ECRI Institute. Among other findings, the review found that short-term ketamine infusions reduced suicide ideation in those suffering from bi-polar disorder, PTSD, or major depressive disorder.
Although some have cast doubt on the research used to support the VA guideline updates, evidence continues to grow supporting the efficacy of ketamine infusions for treating major depressive disorder and PTSD.
Last year, the VA medical center in Cleveland conducted research into ketamine as a solution for treatment-resistant depression. In August 2018, Dr. Punit Vaidya presented the study at the National Press Club in Washington, D.C. He reported that about 30% of people suffering from major depression don’t respond to standard medication. Vaidya told Task & Purpose, a military-focused media company, that a “handful” of veterans participated in study, and spoke he positively of ketamine’s effects.
“When it comes to suicidality, there’s no other medication that’s been demonstrated to have a rapid effect,” he told the publication.
As of September 2018, the study was only in the beginning stages of researching ketamine as an emergency treatment for patients with a high-risk of suicide – patients in imminent danger of self-harm.
“This is a more vulnerable population. High risk. I can’t think of a higher risk population than a veteran that’s in imminent danger of killing themselves,” he said.
But Vaidya cautioned that ketamine infusions are not a stand-alone treatment. “It’s not ‘you get this and you’re done.’” Ketamine infusions are part of a broader treatment plan.
“When it comes to suicidality, there’s no other medication that’s been demonstrated to have a rapid effect.” – Dr. Punit Vaidya
Ketamine for PTSD Relief
Ketamine infusions provide a beacon of hope for veterans suffering from PTSD and major depressive disorder. Nearly 70% of patients who have tried ketamine infusions have found immediate relief.
This initial improvement is temporary, and progressive improvement requires several treatments. But, the rapid improvement after a Ketamine infusion is exciting news for patients with suicidal thoughts and severe depression!