Writing in the medical journal The Lancet, a doctor studying the use of ketamine for the treatment of depression is urging for others to reconsider the benefits of this much stigmatized substance.
Depression affects 350 million worldwide, according to the World Health Organization. Of that, around 16 million of patients are Americans. The complexity and scope of this mental disorder add to the growing burden of the national mental health bill. And antidepressants don’t seem to be working as well for as nearly many people as we would have hoped. It’s time for a change in how we treat depression, say some psychiatrists.
Among those calling for a shift in depression treatment are doctors from Oxford University. The team, led by Dr. Rupert McShane, have been investigating the effects of ketamine as treatment for people with severe, intractable depression, for the past six years. “There are lots of people who are currently resistant to antidepressant drugs and psychotherapies,” said Dr. McShane. And ketamine have provided the answer for some patients.
Ketamine is more well-known as an illicit party drug with high hallucinogenic properties. The drug induces a trance-like state, from which users report relief from pain and other psychological disturbances. In the US, ketamine is classified as a Schedule III drug, alongside other narcotics like Vicodine. In the UK, ketamine is a Class B banned substance.
Dr. McShane said the classification is particularly detrimental for patients who haven’t responded to antidepressants, and consequently don’t have other options. In his trial with over 100 people whose depression did not lessen with conventional treatments, 42 responded to ketamine.
"The first ketamine infusion literally saved my life," said one patient. "I had felt so desperate I was going to end it all. Subsequent ketamine treatment has enabled me to return to my job full-time. I still struggle at times but being able to work again has given me such a boost."
The science behind why ketamine works when other antidepressants fail is still not fully known. But researchers suspect it may be because ketamine targets different receptors in the brain, other than serotonin, norepinephrine or dopamine neurotransmitters like conventional drugs. Ketamine is also fast-acting, which may help its potency from a patient’s perspective.
Dr. McShane is quick to note that the ketamine dosage in his trial is much lower than that used for recreational purposes. But he also cautions against self-medicating with ketamine, as there could be unintended consequences for the untrained user.
Furthermore, he emphasized that ketamine should not be viewed as a miracle drug for depression. There is no such drug that will cure depression in an instant. Rather, the drug may help pull patients out of very dark mental states where they can be more effectively treated for the root causes of their depression.
Additional sources: BBC