A Randomised Study to Evaluate and Compare the Safety of Intravenous vs Intramuscular Ketamine in Major Depressive Disorder with Suicidal Ideations

Background- Depression is a common psychiatric illness that can be very disabling. In severe instances, it can result in suicide. Being an emergency, ketamine has showed rapid response in terminating suicidality and reducing depressive symptoms. Objectives- The aim of the study was to evaluate and compare the safety of intravenous and intramuscular ketamine in major depressive disorder. Method- The present study was conducted in the MDD patients with suicidal ideations who were recruited from psychiatry OPD/IPD during the period November 2021 to October 2022. Ketamine was given at a dose of 0.5mg/kg as a single intravenous infusion in 100 ml NS for a period of 40 minutes or a single intramuscular injection on gluteal muscle and safety of ketamine was assessed on semi-structured proforma. Results- In both groups, most common side effect was anxiety. Other side effects noted were nausea/vomiting, sedation/drowsiness, dizziness, heaviness of head, lightness of body, emotional abreaction, derealisation/depersonalisation, blurred vision, tachycardia, raised blood pressure and elevated mood. All side effects were transient and improved on its own within 24 hours. None of the participants withdrew because of the adverse effects of ketamine. So, ketamine can be a safer alternative when given by im route.