Acting benefits of ketamine for depression and suicidality

Depression Treatment

Depression Treatment

"The interesting U.S. study confirmed the findings from successful studies into intravenous ketamine", said Dr James Stone from Royal College of Psychiatrists, "The main reason for its significance is because this is being developed by a drug company and it's potentially quite likely that this medication might become available as a treatment available on the NHS for depression".

Ketamine - which has a reputation as a party drug - has "shown promise" as a quick treatment for major depression and suicidal tendencies, according to researchers. It was funded by Janssen Research and Development, LLC.

In previous research, intranasal esketamine administered along with usual antidepressants rapidly improved depression symptoms in patients with treatment-resistant depression.

Canuso and colleagues found a significantly greater improvement in depression among patients who received esketamine compared with those who received placebo after 4 hours (effect size = 0.61) and at 24 hours (effect size = 0.65).

The investigators randomly assigned 68 participants to receive esketamine (84 mg) or placebo twice weekly for 4 weeks, along with comprehensive standard-of-care treatment, to determine the change in Montgomery-Åsberg Depression Rating Scale score and suicide risk from baseline to 4 hours after initial dose.

Those who used esketamine had a much bigger improvement in depression symptoms over the first four weeks of treatment, but at 25 days, the effects had evened out. With its fast-relief effect, esketamine could be an important depression drug since most anti-depressants available today take four to six weeks to be effective.

This study was a proof-of-concept, phase 2, study for esketamine; it must still go through a phase 3 study before possible FDA approval.

The effects had levelled out after 25 days, however.

The authors caution that more research is needed on the potential for abuse of ketamine. In an accompanying editorial published along with the study, reports of abuse (including cases of prescribed ketamine) were noted.

However, the researchers, as well as members of the AJP Editorial Board, acknowledged the risky potential for abuse that surrounds the drug.

Overall, the results of the study indicate that the Ketamine nasal spray has the potential to be a fast and effective treatment for patients displaying depressive symptoms and those at imminent risk for suicide. "Protection of the public's health is part of our responsibility as well, and as physicians, we are responsible for preventing new drug epidemics", AJP editor Robert Freedman, M.D. said in a press release published via the American Psychiatric Association. The Editors suggest the need for broad input in the development of effective controls on the distribution and use of ketamine.

Ketamine could be used to treat people at imminent risk of suicide.