Seizure medication shows promise in treating drug-resistant depression
While antidepressants and similar medicines help many living with depression, a significant number of people with depression don’t respond to these medications. Now, a small new study suggests a drug originally intended to manage seizures may also be highly effective in treating depression in those who don’t get relief from antidepressants.
According to the report published in the journal Molecular Psychiatry, a significant number of the 18 patients given ezogabine (also known as Potiga) experienced up to a 45% decrease in depression and depression-related symptoms.
The participants also showed an increase in their ability to feel pleasure, an increase in resilience, and improvements in their capacity to recover from trauma or stress.
“This drug might be relevant for patients who don’t do well with conventional antidepressants,” said lead researcher Dr. James Murrough, the director of the mood and anxiety disorders program at the Icahn School of Medicine at Mount Sinai, in New York City.
Ezogabine was approved by the Food and Drug Administration (FDA) in 2011 for use in treating seizures, but concerns over potential side-effects including retina damage and blindness overshadowed the release of the drug.
Despite later research showing that the drug did not, in fact, damage vision, the drug was still withdrawn from sell in the U.S. due to poor sales.
Murrough and colleagues believe that ezogabine may also be an effective treatment against specific treatment-resistant forms of depression.
As the team explains in their report, antidepressants are effective for a significant portion of those with depression, but not all. Murrough suggests this may be because depression represents a number of different, similar diseases.
If true, this would suggest that different strategies and drugs may be needed to help those who don’t respond to typical treatments.
“Ongoing research is trying to find new ways to treat depression based on understanding what’s going on in the brain when someone gets depressed and how can we reverse that,” Murrough said.
Murrough and colleagues were encouraged to investigate how ezogabine affects areas of the brain responsible for depression after observing that the drug specifically increases the activity in the area of the brain responsible for controlling levels of potassium.
Animal studies have shown that depression may reduce the activity of this region, so a drug that offsets this decrease could be effective at also reducing depression.
To test this idea, Murrough’s team recruited 18 people diagnosed with major depression and administered a daily dose of ezogabine for a period of 10 weeks.
The participants also underwent MRI scans to evaluate how the brain affects the brain’s “reward system.” Based on the scans, ezogabine affectively activated the reward system, which could also be attributed with decreasing depression symptoms.
However, while the drug helped many in the study, not all patients showed improvements. According to Murrough, this may suggest that their condition has a different origin.
Following the promising early results, Murrough and his team hope to undergo a study comparing the results of ezogabine against a placebo, to ensure its effectivity.