Is Ketamine a Viable Option for Treating Depression?
Ketamine has a conflicting reputation. First developed in 1970 as a powerful dissociative anesthetic for humans and animals, the drug has become associated with either surgery on horses or drug-fueled parties – depending who you ask. But, recent studies have suggested the drug could have potential as a treatment for antidepressant resistant depression when administered in proper dosages.
The latest study comes from the University of South Wales’ School of Psychiatry in Australia, who just released the results of a small two-year pilot study that aimed to evaluate the dosage required to balance the maximum efficacy for treating depression with tolerability. This study builds on earlier research showing a correlation between ketamine and antidepressant effects.
“For many drugs, how well it works and side effects are related to dosage. Thus finding the right dose for each person is important,” says study author Colleen Loo. “Our study is the first to systematically examine each person’s response to a range of doses. This is important for the individual patient because we have demonstrated a method to individualize the dose for each person, thus optimizing therapeutic effects and minimizing side effects.”
The study recruited four participants who clinical depression had consistently been non-responsive to traditional antidepressants or more invasive methods suh as electroconvulsive therapy. The study used double blind conditions to administer a range of ketamine doses both intravenously and via a small needle under the skin, similar to how diabetics inject insulin.
Three of the participants showed a response similar to that of antidepressants within 72 hours, though the response faded within one week. However, larger doses brought on side effects including hallucinations and altered perceptions of reality. These side effects subsided within 30 minutes and didn’t require intervention.
While these tests bring ketamine another step closer to being a viable clinical treatment option for depression, they also don’t answer some important questions regarding how the drug actually works to improve depressive symptoms. The researchers say they do know it interacts with an individual’s neurotransmitter systems and animal studies give the suggestion it reverses the deterioration of brain cells associated with depression. However, they are still working to understand the mechanisms causing these changes.
“From what I have seen so far, it will definitely have clinical benefits for some depressed patients. The speed and magnitude of antidepressant response are impressive, side effects are transient and, under medical supervision, it’s safe,” she says, adding that there is still more work to be done. “We are still working out which patients will benefit from ketamine, why it leads to a lasting remission in some and not others, and how to give the drug to optimize effects and gain a lasting response.”