A new study published in the American Psychiatric Association journal suggested that giving a low dose of Buprenorphine after a single infusion of Ketamine helped reduce suicidal thoughts in adults with major depression for a longer time.
The study included 50 adults with major depressive disorder who had serious suicidal thoughts. First, everyone received one ketamine infusion through an IV. Two days later, participants were split into two groups: one group received low-dose buprenorphine, while the other received a placebo for four weeks. Researchers compared the results without knowing who received which treatment until the study ended.
Both groups showed improvement, but the people who received ketamine plus buprenorphine had much greater reductions in suicidal thoughts over time. After four weeks, suicidal thoughts dropped by 76% in the buprenorphine group, compared to 43% in the placebo group.
"This is the second trial to indicate that buprenorphine at low doses reduces suicidal ideation in major depression," said senior author Allen Schatzberg.
"However, unlike earlier reports, the degree of reduction was enhanced markedly by pretreating with intravenous ketamine. The similarities of the buprenorphine findings and the availability of both drugs for clinical use could rapidly increase the potential adoption of the sequence as a treatment strategy to reduce suicidality."
At the end of the study, depression symptoms improved in both groups; however, the difference between them was not large enough to prove that one treatment worked better for overall depression. Importantly, no serious side effects related to the treatment were reported.
The findings are important because there are currently no Food and Drug Administration-approved medications specifically designed to reduce suicidal thoughts in people with major depression. The results also highlighted that ketamine and buprenorphine may reduce suicide risk in ways that are different from simply improving mood.
The researchers said the study was small and did not include people with substance use disorders, so more research is needed to confirm the results, find the best treatment length, and better understand long-term safety and effectiveness.
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