Suicide continues to be a major cause of mortality in adolescents with limited treatment options.1,2 Effective treatments, both therapy and medication, are available for treating depression, but even with the best combination, treatment remission rates are low.3 The most common approach to treating suicidality, which includes suicidal ideation and suicidal behavior, is to address concomitant depression. Ketamine and its enantiomers have shown rapid anti-suicidal effects in adults with MDD, and intranasal esketamine is approved for treating treatment-resistant depression (TRD) in adults.4,5 The effectiveness of ketamine for the treatment of depression frequently lags behind the treatment of suicidality. There are also many methodological differences and barriers to assessing the effectiveness of short-term treatments. These include measurement of change over short time frames, measurement of suicidality, and so forth. Finally, the use of novel short-term treatments in treating chronic depression and suicidality in real-world situations is unclear.
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