Ketamine and Esketamine in Acute Suicidal Presentations: Evidence, Limits, and a Conceptual Recovery-Enabling Downstaging Framework

Objective

To synthesize evidence for intravenous racemic ketamine and regulated intranasal esketamine in adults with acute suicidal presentations; distinguish the outcomes these interventions have and have not been shown to change; and place any rapid response within a complete emergency suicide-care pathway.