{"title":"单次和多次使用氯胺酮对患有精神障碍的成人自杀意念的疗效：荟萃分析","authors":"Wanting Feng , Chengfeng Chen , Yexian Zeng , Bin Zhang","doi":"10.1016/j.pnpbp.2024.111152","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have demonstrated rapid-onset anti-suicidal ideation effects of ketamine. This study aimed to compare the efficacy and duration of anti-suicidal thoughts following single- and repeated-dose ketamine administration.</div></div><div><h3>Methods</h3><div>We retrieved published studies on ketamine for suicidal ideation (SI) from PubMed, OVID (MEDLINE), Web of Science, and Embase, spanning from inception to May 1, 2024. Standardized mean differences (SMD) in the SI scores were calculated for continuous outcomes.</div></div><div><h3>Results</h3><div>This study included 49 independent clinical trials involving 3982 participants. After a single ketamine administration, a significant reduction in SI was observed at 4 h (SMD = −0.607, 95 % confidence interval (CI) = [−0.797, −0.418], I<sup>2</sup> = 40.69 %), with peak effects observed at 24 h (SMD = −0.955, 95 % CI = [−1.229, −0.682], I<sup>2</sup> = 63.66 %) and effects persisted for one month (SMD = −0.948, 95 % CI = [−1.611, −0.285], I<sup>2</sup> = 74.32 %). Similar anti-suicidal effects were observed at the treatment endpoint (SMD = −1.228, 95 % CI = [−1.506, −0.950], I<sup>2</sup> = 94.56 %) and during a follow-up period of greater than or equal to 1 month (SMD = −1.012, 95 % CI = [−1.695, −0.330], I<sup>2</sup> = 80.44 %) with multiple doses of ketamine administration.</div></div><div><h3>Conclusions</h3><div>Single ketamine treatment may have a significant and lasting (up to 1 month) beneficial effect on SI. There was no statistical difference in the efficacy and duration of anti-suicidal thoughts between single and serial ketamine administration.</div></div>","PeriodicalId":54549,"journal":{"name":"Progress in Neuro-Psychopharmacology & Biological Psychiatry","volume":null,"pages":null},"PeriodicalIF":5.3000,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of single and repeated ketamine administration for suicidal ideation in adults with psychiatric disorders: A meta-analysis\",\"authors\":\"Wanting Feng , Chengfeng Chen , Yexian Zeng , Bin Zhang\",\"doi\":\"10.1016/j.pnpbp.2024.111152\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Previous studies have demonstrated rapid-onset anti-suicidal ideation effects of ketamine. This study aimed to compare the efficacy and duration of anti-suicidal thoughts following single- and repeated-dose ketamine administration.</div></div><div><h3>Methods</h3><div>We retrieved published studies on ketamine for suicidal ideation (SI) from PubMed, OVID (MEDLINE), Web of Science, and Embase, spanning from inception to May 1, 2024. Standardized mean differences (SMD) in the SI scores were calculated for continuous outcomes.</div></div><div><h3>Results</h3><div>This study included 49 independent clinical trials involving 3982 participants. After a single ketamine administration, a significant reduction in SI was observed at 4 h (SMD = −0.607, 95 % confidence interval (CI) = [−0.797, −0.418], I<sup>2</sup> = 40.69 %), with peak effects observed at 24 h (SMD = −0.955, 95 % CI = [−1.229, −0.682], I<sup>2</sup> = 63.66 %) and effects persisted for one month (SMD = −0.948, 95 % CI = [−1.611, −0.285], I<sup>2</sup> = 74.32 %). Similar anti-suicidal effects were observed at the treatment endpoint (SMD = −1.228, 95 % CI = [−1.506, −0.950], I<sup>2</sup> = 94.56 %) and during a follow-up period of greater than or equal to 1 month (SMD = −1.012, 95 % CI = [−1.695, −0.330], I<sup>2</sup> = 80.44 %) with multiple doses of ketamine administration.</div></div><div><h3>Conclusions</h3><div>Single ketamine treatment may have a significant and lasting (up to 1 month) beneficial effect on SI. There was no statistical difference in the efficacy and duration of anti-suicidal thoughts between single and serial ketamine administration.</div></div>\",\"PeriodicalId\":54549,\"journal\":{\"name\":\"Progress in Neuro-Psychopharmacology & Biological Psychiatry\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2024-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Progress in Neuro-Psychopharmacology & Biological Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0278584624002203\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Progress in Neuro-Psychopharmacology & Biological Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0278584624002203","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Efficacy of single and repeated ketamine administration for suicidal ideation in adults with psychiatric disorders: A meta-analysis
Background
Previous studies have demonstrated rapid-onset anti-suicidal ideation effects of ketamine. This study aimed to compare the efficacy and duration of anti-suicidal thoughts following single- and repeated-dose ketamine administration.
Methods
We retrieved published studies on ketamine for suicidal ideation (SI) from PubMed, OVID (MEDLINE), Web of Science, and Embase, spanning from inception to May 1, 2024. Standardized mean differences (SMD) in the SI scores were calculated for continuous outcomes.
Results
This study included 49 independent clinical trials involving 3982 participants. After a single ketamine administration, a significant reduction in SI was observed at 4 h (SMD = −0.607, 95 % confidence interval (CI) = [−0.797, −0.418], I2 = 40.69 %), with peak effects observed at 24 h (SMD = −0.955, 95 % CI = [−1.229, −0.682], I2 = 63.66 %) and effects persisted for one month (SMD = −0.948, 95 % CI = [−1.611, −0.285], I2 = 74.32 %). Similar anti-suicidal effects were observed at the treatment endpoint (SMD = −1.228, 95 % CI = [−1.506, −0.950], I2 = 94.56 %) and during a follow-up period of greater than or equal to 1 month (SMD = −1.012, 95 % CI = [−1.695, −0.330], I2 = 80.44 %) with multiple doses of ketamine administration.
Conclusions
Single ketamine treatment may have a significant and lasting (up to 1 month) beneficial effect on SI. There was no statistical difference in the efficacy and duration of anti-suicidal thoughts between single and serial ketamine administration.
期刊介绍：
Progress in Neuro-Psychopharmacology & Biological Psychiatry is an international and multidisciplinary journal which aims to ensure the rapid publication of authoritative reviews and research papers dealing with experimental and clinical aspects of neuro-psychopharmacology and biological psychiatry. Issues of the journal are regularly devoted wholly in or in part to a topical subject.
Progress in Neuro-Psychopharmacology & Biological Psychiatry does not publish work on the actions of biological extracts unless the pharmacological active molecular substrate and/or specific receptor binding properties of the extract compounds are elucidated.
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