A pilot randomized trial of ketamine for suicidal ideation in a pediatric emergency department.
CJEM June 3, 2026 Yury Onikashvili, Heather Burt, Garth Meckler et al.
A pilot trial tested the feasibility of a randomized controlled trial comparing intravenous ketamine (0.5 mg/kg), midazolam (0.03 mg/kg), and saline in adolescents hospitalized for suicidal ideation in the emergency department. Of 21 eligible patients, 15 (71%) agreed to participate. Key barriers to enrollment were limited ED resources and lack of a consenting parent. Retention at 7, 14, 21, and 28 days ranged from 93% to 73%. No serious adverse events occurred. Suicidal ideation scores 90 minutes after infusion were lower in the ketamine and midazolam groups than in the saline group, but the sample was too small for definitive conclusions. The trial design appeared feasible and safe.