One in ten adults in the US suffers from depression. For many, the symptoms are debilitating and the current treatments just don’t work. Researchers say a drug that’s used in hospitals and abused on the streets, may dramatically change your state of mind.

In hospitals, it’s a commonly used anesthetic. In the clubs, ketamine is ‘aka, Special K,’ a popular hallucinogenic drug, but what can make ketamine truly “special” for millions of people, is its potential to, quickly and effectively, treat chronic depression.

“It has been one of the major new findings in the field for at least a few decades,” Doctor Gerard Sanacora, MD., Ph.D., Professor of Psychiatry at Yale University and Director of the Yale Depression Research Program, told Ivanhoe.

Unlike standard antidepressants, which can take weeks or months to work, Yale researchers say ketamine can improve your mood in hours, “by reconnecting brain regions and allowing proper control of mood and emotion," Doctor Ron S. Duman, Ph.D., at Yale University School of Medicine, told Ivanhoe.

Even for treatment-resistant patients. However, researchers are still figuring out how to safely administer ketamine as a routine treatment. “It’s not strongly addictive, but it does have high abuse potential,” Doctor Duman said.

While ketamine is currently not FDA approved for depression, a growing number of private clinics across the country are offering it “off label.” Doctor Gerard Sanacora is concerned. “There are several very important questions that we still don’t know about ketamine and probably the most important is what is the long term benefit? Is repeating dosing of this actually a good idea,” said Doctor Sanacora.

Doctors say the fast-acting quality of ketamine can help save lives of those in danger of committing suicide. Infusions at the private ketamine clinics can run you thousands of dollars, with no guarantee of any results; they’re also not covered by insurance.   

 

DEPRESSION: Depression can come in many forms, but when the symptoms begin to interfere with people’s daily lives these feelings become an illness. Signs of depression include feelings of hopelessness or guilt, loss of interest in activities that used to be enjoyable, thoughts of suicide, and many more. Some people have minor bouts of depression, but major depressive disorder can be disabling. Other forms of depression are postpartum depression, which occurs after giving birth, and seasonal affective disorder, which comes on during the winter months due to lack of natural sunlight. Medications and psychotherapy may help to alleviate depression symptoms, but are ineffective in helping some individuals. (Source: http://www.nimh.nih.gov/health/topics/depression/index.shtml)

 

KETAMINE: The drug ketamine was first developed in 1963 to be used as an anesthetic in humans as well as animals. When used for medical purposes, ketamine comes as a liquid that is injected into patients and is chemically similar to PCP. Although doctors and veterinarians continue to administer the drug as an anesthetic, ketamine is also used recreationally as a “street drug.” Typically snorted or ingested in powder form, ketamine has been known to cause dream-like states and hallucinations. When taken in large amounts ketamine can cause an effect called the “K-hole” in which people experience an inescapable, often terrifying out-of-body experience. (Source: http://www.drugfree.org/drug-guide/ketamine)

 

MEDICAL BREAKTHROUGH:  A new study, conducted by researchers at the Baylor College of Medicine in Houston and Mount Sinai School of Medicine in New York, shows that the experimental party drug, ketamine, can alleviate depression symptoms in just hours. The drug was shown to quickly reduce depression in participants after just one 40-minute IV dose. Most medications available today can take days, if not weeks, to reduce symptoms. The drug also has long-lasting results. After one week, 46 percent of the ketamine-assigned patients still reported reduced depression symptoms after taking the ketamine, compared to 18 percent in the placebo group. Although the ketamine has obvious benefits, it is still a hallucinogenic drug that is very dangerous. (SOURCE: www.huffingtonpost.com/2013/05/22/ketamine-cures-depression-study)

 

 

Ron S. Duman, PhD, Professor of Psychiatry and Neurobiology at Yale University School of Medicine, talks about a new treatment option for depression.

What causes depression? 

Dr. Duman: Depression is a complex illness that has a complicated neurobiology.  One of the things that has been the focus of research is that there is a decrease in the size of brain regions that are implicated in depression and evidence that there is atrophy of these brain regions. In other words, there is evidence that the brain may undergo atrophy in response to stress and exposure to depression.  And evidence from animal studies has shown that stress actually causes atrophy of neurons in brain regions implicated in depression.  

Now how big of a deal is ketamine in depression research? 

Dr. Duman: Ketamine is major finding in the field of depression.  It is the first compound, first drug with a new mechanism of action different from the typical antidepressants like the serotonin reuptake inhibitors. The significance of ketamine is based on the fact that it produces a very rapid response within a matter of hours, compared to the very slow onset of action of drugs like the serotonin selective reuptake inhibitors, which take weeks to months. Ketamine also works in patients who are considered treatment resistant, in that they have not responded to the typical antidepressants.  By virtue of the fact that it is a new mechanism of action, that it acts very rapidly in a difficult to treat group of patients, indicates that ketamine is one of the biggest findings in almost 50 years in the field of depression. 

How does the drug work in a simplified form?

Dr. Duman: Ketamine acts on the glutamate neurotransmitter system, which is the major excitatory system in the brain. The evidence indicates that it is actually causing a burst of glutamate activity, very rapid, but transient burst of glutamate activity that then sets up a cascade of events leading to an increase in synaptic connections that we believe is responsible for the antidepressant effect of ketamine, by reconnecting brain regions and allowing proper control of mood and emotion.

You said that this is good for people who are resistant. Can you just explain a little bit more as to why they make better candidates than for this drug regime?

Dr. Duman: Up until now, ketamine has been used primarily in research protocols and research studies. Usually patients who are nonresponsive or are very ill are those that qualify for these types of studies. So we do not know yet. We certainly think that ketamine would be very effective for the general depressed population, but the fact that ketamine works in these treatment-resistant patients is a really important aspect of what ketamine is able to do.

Can you tell us a little bit more about what your studies showed?