Ketamine, known as Special K in the party culture, is being used to combat severe depression and suicidal thoughts in patients who do not respond to traditional therapy.
Ketamine has been around since the 1960s and is a powerful sedative that essentially leaves the user unresponsive and physically detached from the senses. It is most often used in emergency rooms and on children with a broken or dislocated bone.
The drug is also popular in veterinary medicine and burn centers.
Over the past several years, ketamine effectiveness has been studied in patients suffering from severe depression who are resistant to traditional depression management. So far, research has shown that the drug produces a quick and strong antidepressant effect while ending suicidal thoughts in the patient.
Conventional antidepressants and mood stabilizers typically take weeks or even months before the effects are noticed. According to a study published in 2010, many generally accepted antidepressants are no more effective than placebos.
Several medical centers, including Yale University, the University of California at San Diego, the Mayo Clinic, Kaiser Permanente, and the Cleveland Clinic, have all begun ketamine treatment for depression. The American Psychiatric Association is currently on track to approve the drug as a practical antidepressant therapy.
Many health experts consider ketamine the most significant advancement in mental health within the last 50 years. The drug is gaining momentum since it seems to be working for many patients, while other antidepressants, mood stabilizers, and various therapies have not.
“This is the next big thing in psychiatry,” said San Francisco psychiatrist L. Alison McInnes. After using ketamine treatment on 58 severely depressed patients in Kaiser’s San Francisco clinic, she found a 60 percent success rate. Her results were significant enough to persuade Kaiser to allow the treatment in two other area clinics.
Other than ketamine, some depression patients do not have any real alternative options.
“There is a significant number of people who don’t respond to antidepressants, and we’ve had nothing to offer them other than cognitive behavior therapy, electroshock therapy and transcranial stimulation,” noted McInnes.
Dennis Hartman, a Seattle business executive, was seriously considering suicide in 2012. However, he had the opportunity to participate in a ketamine clinical trial at the National Institute of Mental Health in Bethesda, Maryland.
During the test, he sat in a hospital room for 40 minutes while an IV drip delivered a small amount of ketamine into his system. Within hours of the treatment, he noticed that all the thoughts of suicide had left him.
“My life will always be divided into the time before that first infusion and the time after,” Hartman said. “That sense of suffering and pain draining away. I was bewildered by the absence of pain.”
The study found that the dosage needed to make a difference is very small, about 10 percent of the amount used in anesthesia. Not only that, the effects are observed within minutes or hours.
Enrique Abreu, a Portland, Oregon, anesthesiologist, began treating depressed patients with ketamine in 2012.
“It’s not subtle. It’s really obvious if it’s going to be effective. And the response rate is unbelievable. This drug is 75 percent effective, which means that three-quarters of my patients do well. Nothing in medicine has those kind of numbers.”
While the clinical trials have shown much success, there is one major drawback to the treatment. The depression relief is only temporary. Many patients experienced a relapse of depression symptoms about a week after an infusion.
Additionally, patients getting the low-dose infusion have described some mind-altering side effects like intense hallucinations, a feeling of being separated from their bodies, and losing track of time. Interestingly, some enjoy the side effects, while many do not.
Despite the side effects, low-dose infusion of ketamine for depression treatment looks to be promising. The drug is also being studied for treating obsessive-compulsive disorder, post-traumatic disorder, extreme anxiety, and Rett syndrome.
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