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Ketamine Treatment for Suicidal Ideation
Ketamine Treatment for Suicidal Ideation at ACE Medical in Sunnyvale, CA
When suicidal thoughts won’t let up, it can feel like there is no way out. Many people who come to ACE Medical have already tried multiple medications, therapy, or even hospitalizations and still feel overwhelmed by suicidal ideation.
If you live in Sunnyvale, CA or the greater Santa Clara County area, you are not alone—and you are not “broken” for feeling this way. Many people in and around Sunnyvale, Mountain View, Cupertino, and San Jose quietly struggle with such thoughts.
In recent years, ketamine-based treatments have shown that they can rapidly reduce suicidal thoughts in many adults, sometimes within hours to a few days, when given in a controlled medical setting.[2–8]
At ACE Medical, an addiction medicine practice based in Sunnyvale, California, we offer ketamine treatment in a way that is: Focused on safety, Grounded in evidence, Sensitive to addiction risk, and Compassionate and nonjudgmental
Our mission is to help you move from constant crisis to a place where life feels even a little more manageable, and then build up from there.
What is suicidal ideation?
Suicidal ideation means having thoughts about ending your life, ranging from fleeting “I wish I wouldn’t wake up” thoughts to detailed plans with intent to act.
These thoughts can be:
-Passive (“I’d be better off dead”)
-Active (“I am planning to hurt myself”)
-Constant or come in intense waves
-Connected to depression, trauma, anxiety, substance use, or overwhelming life stress
Having suicidal thoughts does not mean you are weak or broken. It means your pain has reached a level where your brain is struggling to see any other way to escape it. Treatment at ACE Medical is about reducing that pain, rebuilding hope, and keeping you safe while we do it.
What is ketamine treatment for suicidal ideation?
Ketamine is a medication originally used as an anesthetic. At much lower doses, it acts as a fast-acting antidepressant that can significantly reduce suicidal thoughts in many adults with major depression.[2–7]
In mental health care, including at ACE Medical, ketamine is:
-Given in sub-anesthetic doses (you are awake, not “knocked out”)
-Administered as IV infusions or as esketamine (Spravato®) nasal spray
-Provided only in a monitored clinic setting, never to take home
-Combined with an overall treatment plan, not used in isolation
Ketamine is not a cure for suicidal thoughts or depression. But evidence shows it can create a rapid, meaningful reduction in suicidal ideation, often much faster than traditional antidepressants.[3–7]
How does ketamine help with suicidal thoughts?
Traditional antidepressants can take 4–6 weeks to work. Ketamine works differently, primarily through the glutamate system in the brain by doing the following:
-Blocks NMDA receptors
-Enhances AMPA receptor activity
-Activates signaling pathways (like mTOR) that help repair and regrow connections between brain cells
These changes are thought to rapidly improve communication in brain regions involved in mood, thinking, and impulse control.[4,6]
Clinical trials and meta-analyses have found that:
-Ketamine can reduce suicidal thoughts within 4–24 hours after a single dose, with effects lasting several days to a week for many patients.[2,3,5,6,8]
-Repeated doses over a short series (for example, several infusions over 2–3 weeks) may further strengthen and extend these benefits.[3,7,9]
-Benefits appear partly independent of general mood improvement, suggesting a specific effect on suicidal thinking itself.[3,5]
That said, ketamine has not been proven to prevent suicide or eliminate risk entirely. It is one important tool at ACE Medical, used alongside safety planning, therapy, and sometimes hospitalization when needed.[10]
What types of ketamine treatments does ACE Medical offer for suicidal ideation?
At ACE Medical, we typically consider two medically supervised options:
1. IV Ketamine Infusions (Off-Label for Suicidal Ideation)
Uses racemic ketamine (the original form of the drug)
Administered through a slow IV infusion over about 40–60 minutes
Backed by numerous trials showing rapid reductions in suicidal thoughts in adults with major depression[2,3,5,7]
While in process for FDA-approval specifically for suicidal ideation, IV ketamine is widely used off-label in specialist clinics with growing real-world evidence.[9]
2. Esketamine Nasal Spray (Spravato®) for Depressive Symptoms with Suicidal Ideation
Esketamine is a related medication derived from ketamine
FDA-approved for:
Adults with treatment-resistant depression
Depressive symptoms in adults with major depressive disorder (MDD) and acute suicidal ideation or behavior, used with an oral antidepressant[10–12]
Given as a nasal spray in the office while you’re monitored for at least 2 hours
Importantly, the FDA label notes that esketamine’s ability to prevent suicide or reduce suicidal behavior long-term has not been demonstrated, so it does not replace emergency or inpatient care when needed.[10]
When you come to ACE Medical, we’ll review which option (if any) is appropriate for you based on your diagnosis, severity of suicidal thoughts, medical status, and other treatments.
Will I still need other treatment if I receive ketamine?
Ketamine is not meant to replace other forms of care. The best outcomes usually occur when ketamine is part of a comprehensive treatment plan for suicidal ideation that may include:
-Ongoing talk therapy (individual, group, family)
-Safety planning and crisis resources
-Antidepressant or mood-stabilizing medications
-Sleep, nutrition, exercise, and stress-management strategies
-Addiction treatment and recovery support if needed
Think of ketamine as a powerful reset that can help quiet suicidal thoughts enough so you can more fully engage in the work of healing.
When should I consider ketamine at ACE Medical vs. emergency care?
You should seek immediate emergency help (call 911 or go to the ER) if:
-You have a specific plan to harm yourself
-You feel unable to stay safe on your own
-You have just attempted self-harm or taken an overdose
Ketamine is not an emergency-room replacement. It is considered when:
-You are medically safe enough for outpatient treatment
-You have ongoing suicidal ideation that has not responded to other treatments
-You are ready to engage in follow-up care and safety planning
If you’re unsure which applies to you, you can call our office, talk to your current provider, or call/text 988 for immediate guidance and support.[1]
Take the First Step Toward Better Health
Whether you're seeking Ketamine treatment for suicidal ideation, or other mental health or addiction challenges, let ACE Medical be your trusted partner in care.
Experience care that’s personal, proactive, and centered around you.
References:
1. U.S. Government. Find Help for Mental Health. USA.gov / Suicide & Crisis Lifeline (988).
2. Murrough JW et al. Ketamine for rapid reduction of suicidal ideation in major depression. Am J Psychiatry. 2015.
3. Wilkinson ST et al. The effect of a single dose of IV ketamine on suicidal ideation in treatment-resistant depression. Depress Anxiety. 2018.
4. Zolghadriha A et al. Rapid and sustained antidepressant effects of intravenous ketamine on MDD and suicidal ideation. BMC Psychiatry. 2024.
5. Shen ZY et al. Meta-analysis of the effects of ketamine on suicidal ideation. Transl Psychiatry. 2024.
6. Abbar M et al. Ketamine for the acute treatment of severe suicidal ideation. BMJ. 2022.
7. Barbara AM et al. Ketamine for adults with treatment-resistant depression: 2023 update. CADTH/NCBI Bookshelf. 2024.
8. Seyedoshohadaei SA et al. Ketamine’s efficacy in alleviating acute suicidal thoughts: systematic review and meta-analysis. Middle East Curr Psychiatry. 2024.
9. Chen-Li DCJ et al. Effect of IV ketamine on suicidality in adults with depression: real-world study. Psychiatry Res. 2025.
10. U.S. FDA / Janssen. SPRAVATO (esketamine) prescribing information and updates, including indication for MDD with acute suicidal ideation or behavior. 2019–2025.
11. Sanacora G et al.; VA / DoD. IV Ketamine infusion for treatment-resistant depression and rapid reduction of suicidal ideation: clinical guidance and protocols. 2022–2025.
12. Kumari S et al. Exploring esketamine’s therapeutic outcomes as an FDA-approved treatment for MDD with suicidal ideation. 2024.
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