Ketamine News

Joe Wright has no doubt that ketamine saved his life. A 34-year-old high school teacher who writes poetry every day on a typewriter, Wright was plagued by suicidal impulses for years. The thoughts started coming on when he was a high schooler himself, on Staten Island, N.Y., and intensified during his first year of college. “It was an internal monologue, emphatic on how pointless it is to exist,” he says. “It’s like being ambushed by your own brain.”

He first tried to kill himself by swallowing a bottle of sleeping pills the summer after his sophomore year. Years of treatment with Prozac, Zoloft, Wellbutrin, and other antidepressants followed, but the desire for an end was never fully resolved. He started cutting himself on his arms and legs with a pencil-sharpener blade. Sometimes he’d burn himself with cigarettes. He remembers few details about his second and third suicide attempts. They were halfhearted; he drank himself into a stupor and once added Xanax into the mix.

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Two new studies suggest the psychiatric benefits of ketamine treatment may extend beyond just the targeting of depression. The research demonstrates ketamine may be helpful in targeting both anxiety- and substance abuse-related depression.

Although ketamine is a relatively old drug, originally developed in the 1950s as an anesthetic, over the last decade a growing body of research has affirmed its unique, and rapid, antidepressant effects. The anecdotal effects of the drug on depression have raced ahead of scientific research so quickly that ketamine clinics have popped up all across the United States, where the drug can be administered for up to US$1,000 a dose.

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In May of 2017, Louise decided that her life was just too difficult, so she’d end it. In the previous four years, three siblings and a half-sibling had died, two from disease, one from fire and one from choking. Close friends had moved away. She felt painfully, unbearably alone. It would be the fourth time Louise (I’m using her middle name to protect her privacy), then 68, would attempt suicide, and she was determined to get it right.

She wrote a letter with instructions on where to find important documents and who should inherit what. She packed up her jewelry and artwork, addressing each box to particular friends and family members. Then she checked into a motel — homes where people have committed suicide lose value and she didn’t want hers to sell below market — put a plastic sheet on the bed, lay down and swallowed what she figured was an overdose of prescription pills with champagne.

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Ketamine infusions elicit different responses among 3 distinct subgroups of individuals dealing with depression and suicidal ideation. One group, remitters, had no suicidal ideation by day 2, and another group, responders, showed improvement independent of depressed mood, according to a study published in the Journal of Affective Disorders.

Researchers pooled data from 5 clinical trials involving treatment-resistant individuals with major depressive disorder or bipolar depression (N=128). All participants received a ketamine infusion and were evaluated at baseline and days 1 through 3. Evaluations included plasma markers to monitor neurotrophic factors, kynurenine pathway analytes, inflammatory cytokines, cortisol, and suicidal ideation composite scores to monitor depressed mood, hopelessness, sadness, and suicidal thoughts.

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Ketamine, a widely used anesthetic that’s also an illicit party drug, has taken on a new role in recent years: treating severe depression in people who have not responded to standard treatment. Researchers have called it the most exciting breakthrough in the field of depression research in the past half-century.

One form of the drug, being developed as a nasal spray called esketamine, is in the final stages of testing needed before it can go to the FDA for approval.

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A low dose of ketamine infusion can provide a rapid and sustained antidepressant effect in patients with treatment-resistant depression, according to a study published in the Journal of Affective Disorders. In addition, a subanesthetic dose of ketamine was shown to improve functional impairment traditionally associated with treatment-resistant depression.

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Average scores on the Children's Depression Rating Scale dropped by 42.5% following low-dose IV ketamine infusions among 13 teenagers with treatment-resistant depression, findings published in Journal of Child and Adolescent Psychopharmacology showed.

“Adult [treatment-resistant depression] research has begun to explore repeated administrations of ketamine, which may have promise for greater effectiveness and longer remission periods than single doses,” Kathryn R. Cullen, MD, division of child and adolescent psychiatry, University of Minnesota Medical School, and colleagues wrote.

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Adolescents treated with intravenous ketamine for treatment-resistant depression showed a significant average decrease— 42.5%—in Children’s Depression Rating Scale scores, according to a small, open-label study published online in the Journal of Child and Adolescent Psychopharmacology.

“Novel interventions for treatment-resistant depression (TRD) in adolescents are urgently needed,” wrote researchers. “Ketamine has been studied in adults with TRD, but little information is available for adolescents.”

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In patients with severe depression and thoughts of suicide, ketamine is emerging as a potential treatment. Patients are given roughly 5 to 6 injections of the party drug and have reported almost immediate relief from suicidal thoughts and major depressive disorder.

One such patient, Alan Ferguson, had been battling depression his whole life and had attempted suicide multiple times. In the midst of a major depressive episode, the 54-year-old was put in touch with Dr. Kevin Lane, an anesthesiologist who is currently administering ketamine treatments. After receiving one treatment of intravenous ketamine therapy, Ferguson claims to have woken up the next day with no thoughts of suicide. Receiving three of the injections in total, he describes the drug as a “medical marvel”.

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A few months ago, Alan Ferguson decided he was ready to die -- for the third time. In 2014, he attempted suicide twice, and the persistent thoughts of "I need to be dead" were echoing in his brain once again.

Now 54 years old, Ferguson was diagnosed with clinical depression when he was 18. Since then, he estimates, he's been prescribed more than a dozen medications -- SSRIs, SNRIs, tricyclic antidepressants -- all to little or no avail.

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A new study has shown a significant average decrease in the Children's Depression Rating Scale (42.5%) among adolescents with treatment-resistant depression (TRD) who were treated with intravenous ketamine. The study, which demonstrated the tolerability and potential role of ketamine as a treatment option for adolescents with TRD, is published in Journal of Child and Adolescent Psychopharmacology.

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There’s a new treatment that’s gaining traction as a wonder drug for depression — and that’s ketamine. According to its advocates, medically administered ketamine infusions have the potential to revolutionize the way doctors treat depression — and give people struggling with depression unprecedented relief from their symptoms.

For people struggling with depression, treatment is crucial. Unfortunately, traditional treatments don’t work for everyone; about 30% of people with depression don’t respond to traditional pharmaceutical treatment, and even for people who do respond, antidepressants can take up to eight weeks to take effect — which, when you’re struggling with depression, can feel like a lifetime.

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A North Texas woman said a popular club drug and animal tranquilizer saved her from a life of depression and suicidal thoughts.

You may have heard of the drug before, as Special K on the street. it was designed as a horse tranquilizer, but Ketamine is gaining popularity as a treatment for depression.

Some doctors believe the controversial drug will become a game-changer in slowing the nation's suicide epidemic.

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I am here because I cannot stop thinking about suicide. I’ve been in therapy on and off for more than 30 years, since I was 5, and on depression medication for more than a decade. Nothing seemed to work. I couldn’t stop imagining killing myself in increasingly vivid daydreams.

As a journalist who covers health and medicine, I had read about the success of experimental trials that used ketamine to treat depression. My therapists had recommended extreme treatments like electroshock therapy, a procedure that frightened me due to reports of memory loss from those who had undergone it, but had never mentioned this. But I was getting desperate for a serious intervention.

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Ketamine was developed as an anesthetic for surgery and trauma. It was approved by the FDA in 1970 for human use, with indications as for the sole anesthetic agent for diagnostic and surgical procedures that do not require skeletal muscle relaxation. Ketamine was then literally battle-tested during the Vietnam War, where it was vital in caring for wounded soldiers.

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While depression is a treatable condition, some individuals do not respond to conventional prescription medications or talk therapies.

It can be a long and frustrating road for those with treatment-resistant depression who seek help, but Dr. Pierre Blier, Director of Mood Disorder Research at The Royal’s Institute of Mental Health Research (IMHR), has been able to offer hope to some of these individuals, via a cutting-edge treatment that uses an old drug in a new and effective way.

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RENO, Nev. — Dr. Robert Watson was walking to the hospital one day when he heard a woman call out to him.

The woman, he quickly realized, was the mother of a patient whom he recently treated. "She told me, 'Oh my gosh! Thank you; thank you so much!'" Watson recalled.

Not long before, the woman had called Dr. Watson's office out of desperation. She was seeking help for her daughter, who was suffering from an anxiety disorder — she was crippled by it and unable to work.​

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Ketamine has caused quite a stir in psychiatric practice. Sub-anesthetic administrations of ketamine have been shown to markedly improve symptoms of depression and anxiety. While the growing off-label use of ketamine speaks to the need for novel approaches to psychiatric care and treatment-resistant illness, it also presents an ethical dilemma, wherein widespread adoption has once again leaped ahead of scientific understanding.

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For six years now, life has been really good for James. He has a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids.

And it has all been possible, he says, because for the past six years he has been taking a drug called ketamine.

Before ketamine, James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes.

Ketamine "helped me get my life back," says James.

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Every week, when Ian Hanley sits down with his therapist, he goes through a list of depression treatments he’s been researching online. The best-known treatments at the top of the list–half a dozen antidepressants and known combinations of those drugs–are all crossed out.

“My therapist says he’s never had this much difficulty with somebody,” says Hanley, “which is sort of a dubious honor.”

Hanley is only 21 years old, but he’s already six years into his search for something, anything, that can help him feel better for more than a few weeks at a time.

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Results of a recent study indicate that response to ketamine treatment in mood disorders may be better predicted based on existing baseline metabolic-inflammatory alterations, most notably cognitive impairment.

Researchers aimed to identify mood disorder subpopulations that were more, or less, likely to respond to treatment with ketamine. Current literature indicates that ketamine has a quick antidepressant effect on treatment-resistant depression symptoms in patients with both major depressive disorder (MDD) and bipolar disorder. The authors focused their study on predictive pretreatment elements in these disorders.

They searched PubMed/MEDLINE, ClinicalTrials.gov, and Scopus for relevant literature and bibliographies that included terms such as major depressive disorder, depression, bipolar disorder, remission.

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Like a May shower, the studies on psychedelic drugs' potential therapeutic benefits came — first as a sprinkle, then a steady downpour. Between 2012 and 2017, the papers abounded. One, published in 2016, suggested that magic mushrooms might alleviate anxiety in cancer patients; another in 2017 indicated that ecstasy could help veteranscope with PTSD symptoms; and one in 2012 hinted that ketamine might curb major depression.

Recently, the shower has turned into a trickle. But that spate of published research on psychedelics now seems to be leading to the development some promising potential treatments.

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It all started with ketamine. To some, vets mainly, it’s a horse tranquilizer. To others, a party drug. To those with severe clinical depression, a potential, literal, life-saver. A dose of ketamine can rapidly dull the symptoms of depression, providing immediate relief for those crippled by the darkest thoughts. And while ketamine does not work for everyone, it seems to work in many people who are untouched by standard antidepressant drugs.

Ketamine could then be our best lead in the hunt for depression. For if we search for where ketamine affects the brain, and for how it affects the brain, we will get vital clues to the cause of depression. And so to a long-lasting effective treatment. Two studies just published in Nature used precisely this trick, and spectacularly uncovered not just compelling evidence of the tiny brain region to target, but exactly what goes wrong in it to create depression — that some neurons are, literally, depressed.

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When confronted with a suicidal patient, doctors could turn to a substance with uses that range from psychedelic party drug to animal anesthetic.

It’s called ketamine, a class III scheduled drug known for its similarities to PCP and its ability to induce dissociative and hallucinogenic feelings. The drug is the most commonly used among veterinarians for anesthetic purposes, according to Medical News Today, but is often illegally used in clubs and as a date-rape drug.

And now a study published in The American Journal of Psychiatry suggests the powerful drug could also help treat suicidal people.

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Don’t people take ketamine at raves?
Well, yeah. Club kids call it Special K and snort it for its dissociative, dreamy effects. But it’s also been used as a (legal) anesthetic since the ’70s. In the early 2000s, doctors realized it quickly treats depression and began prescribing it in small doses. Researchers theorize it works by blocking cells from firing in the lateral habenula, an area of the brain that represses reward centers, according to a study released in February. (Maybe it’s also got something to do with those dissociative effects?)

How does it get administered at clinics?

First, you need a prescription from your doctor. Then, after a consultation at the clinic, you’ll hang out in a recliner for 45 minutes or so while an IV drip infuses the drug into your bloodstream. A nurse monitors your blood pressure and heart rate. (Be wary if the clinic doesn’t track your vitals.)

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It's been called "the most important discovery in half a century," and for some of the people who have tried ketamine, it may feel that way too.

The compound has a reputation as a party drug, but ketamine is increasingly being studied for its potential use as a rapid-fire treatment for depression. In people who live with the disease, thoughts of suicide can strike suddenly and without warning. Fast-acting, successful interventions are hard to come by.

But a spate of recent research suggests that ketamine could provide quick and powerful relief — even to people whose depression has repeatedly failed to respond to other medications and to those who are suicidal.

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The notorious party drug may act as an antidepressant by blocking neural bursts in a little-understood brain region that may drive depression​.​​

Ketamine has been called the biggest thing to happen to psychiatry in 50 years, due to its uniquely rapid and sustained antidepressant effects. It improves symptoms in as little as 30 minutes, compared with weeks or even months for existing antidepressants, and is effective even for the roughly one third of patients with so-called treatment-resistant depression.

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Unipolar major depressive disorder (MDD) is one of the leading causes of disability, affecting 16 million individuals in the United States, and more than 300 million individuals worldwide experience depression. Roughly one-third of patients with MDD do not respond to currently approved antidepressants, and even in those who do, these agents typically take several weeks or even months to achieve a significant effect.

“There is a major unmet need for more effective and rapidly acting antidepressants,” commented Dan V. Iosifescu, MD, director of clinical research, at the Nathan Kline Institute and associate professor of psychiatry at New York University School of Medicine.

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