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Lori Calabrese, MD

Innovative Psychiatry

Could Ketamine Help Cure Depression?

Ketamine is an illicit drug known as “Special K”, but it could have some legit antidepressant effects.

By Rachel Jacoby Zoldan | May 16, 2017

Depression is more common than you might think. It affects more than 15 million Americans, and the World Health Organization estimates that number grows to 300 million when you expand globally. There are a slew of different treatment options available to help alleviate its symptoms—think anxiety, insomnia, fatigue, and loss of appetite among others—with the most common treatment being serotonin reuptake inhibitors (or SSRIs). But since about 2000, doctors and researchers have been experimenting with ketamine—originally a pain management pharmaceutical, now abused as a street drug because of its hallucinogenic effects—as another potential way to treat the condition, according to Ruben Abagyan, Ph.D., a pharmacology professor at the University of California San Diego (UCSD).

You’re probably thinking, “Wait! What?” If you’ve heard of ketamine, also known as Special K, you know it’s no joke or generic OTC drug. In fact, it’s known as a dissociative anesthetic (meaning a drug that distorts perception of sight and sound, while producing literal feelings of detachment from the self and the environment). It’s primarily used by veterinarians for treating pain in animals, but it can also be prescribed to people for severe pain management, particularly those with neuropathic issues, a kind of chronic nerve pain, according to a 2014 study published in the British Journal of Pharmacology.

“It’s known that pain and depression are linked,” says Isaac Cohen, a pharmacological student who worked on the study. “Depressed people are more likely to dwell on pain and people in chronic pain are more likely to become depressed due to decreased mobility, a lessened ability to exercise, and other factors, he says. “Ketamine is unique because it may treat both pain and depression simultaneously, leading to better outcomes for both conditions.” And now scientists are arguing there’s not just anecdotal evidence, but also statistical information that shows ketamine can help lessen the symptoms of depression.

In the first-ever large-scale analysis of its kind, published in Nature, researchers found that patients who received ketamine reported significantly lower instances of depression. This research, conducted by the School of Pharmacy and Pharmaceutical Sciences at the UCSD, reinforces anecdotal data and small population studies that have also suggested ketamine’s antidepressive effects.

What sets ketamine apart from other treatments, specifically, is how quickly it takes effect. “Current FDA-approved treatments for depression fail for millions because they don’t work fast enough,” says Abaygan. Ketamine works in a matter of hours. That’s far less than SSRIs, for example, which can take six to ten weeks to reach their full capacity. And that difference in timing could quite literally be a matter of life or death, especially with those who are experiencing suicidal thoughts.

For their research, Abaygan and his team reviewed data from the FDA’s Adverse Event Report System, an agency which collects information about adverse effects (or unintentional effects of any kind) of any approved drug that has been reported by pharmacists and doctors. Specifically, they found 40,000 patients who were prescribed medication for pain and separated them into two groups—those who took ketamine and those treated with alternative pain medications (excluding NSAIDs).

The results showed a rather significant “bonus,” albeit unintended, effect. Half of the people who treated their pain with ketamine reported being less depressed than those who had taken alternative kinds of pain-reducing medication. Although we don’t know whether any of these patients, particularly those on ketamine, were experiencing depressive symptoms before taking any meds, the positive effect on mood, coupled with the common link between pain and depression, could warrant further discussion on ketamine’s use to treat depression more directly.

According to the researchers, ketamine is relatively inexpensive and if you’ve previously tried at least three other antidepressant medications with no success, it is typically covered by most health insurance plans. Point being? Don’t be so quick to write off ketamine just as a hallucinogen. It might really be special after all. (And if nothing else, guys, check out these ways to manage stress or depressive feelings at any time.)

[Read the Original Article Here]
  • « No. 7 Medical Innovation for 2017: Ketamine for Treatment-Resistant Depression (Video)
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Meet Dr. Calabrese

Meet Dr. Calabrese

Practicing Board Certified Psychiatrist. Speaker at Oxford, APA, KRIYA & ASKP. Trail blazing excellence in psychiatry through research and innovation. 
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