Ketamine for Depression: The Most Important Advance in Field in 50 Years?

In a new review in Science, the authors call the identification of the anesthetic and “club drug” ketamine as a rapid treatment for depression “arguably the most important discovery in half a century” of research on the condition

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In any given year, 7% of adults suffer from major depression, and at least 1 in 10 youth will reckon with the disorder at some point during their teenage years. But about 20% of these cases will not respond to current treatments; for those that do, relief may take weeks to months to come.

There is one treatment, however, that works much faster: the anesthetic and “club drug” ketamine. It takes effect within hours. A single dose of ketamine produces relief of depression that has been shown in studies to last for up to 10 days; it also appears to reduce symptoms of bipolar disorder and suicidal thoughts.  Now, a new research review published in Science calls the discovery of these effects of ketamine, “”arguably the most important discovery in half a century” of depression research.

Ketamine doesn’t work the way traditional antidepressants do. Many such drugs affect levels of the neurotransmitter serotonin in the brain, and while the idea that depression is caused by low levels of serotonin or an “imbalance” of other key neurotransmitters has been firmly fixed in the popular imagination, scientists have known for decades that it can’t be that simple. For one, antidepressant drugs change the brain’s neurotransmitter levels immediately, yet depression doesn’t lift for several weeks, a delay that could be potentially deadly.

Another theory is that depression is caused not by neurotransmitter problems per se, but by damage to brain cells themselves in key regions critical to controlling mood. This idea fits nicely with evidence that stress can cause depression, since high levels of stress hormones can cause an overrelease of a neurotransmitter called glutamate, which damages cells and affects exactly the same suspected areas. More support for this theory comes from the fact that all known antidepressants increase cell growth in these areas too, providing an alternate explanation for their therapeutic results.

At first, ketamine seemed to throw a monkey wrench into that neat idea, however. It didn’t seem likely that a drug could repair cells within hours, but new research explored in a review paper in the journal Science suggests just that. Ketamine rapidly spurs the growth of new synapses, the connections between brain cells, and is associated with “reversal of the atrophy caused by chronic stress,” the authors write.

Unfortunately, the hallucinogenic and often outright unpleasant effects of ketamine mean that it can’t be used in the same way typical antidepressants are, and fears about its potential for misuse also hamper its development. Researchers are frantically trying to develop compounds that have the same effects as ketamine without producing a “high.”

In the meanwhile, however, ketamine is already FDA approved, so there’s nothing stopping psychiatrists from trying it and patients from asking for access to it in emergency situations when all else has failed. However, it must be given by infusion and carefully monitored (nasal sprays are being developed and there is an oral form that has some effects, but is not optimally absorbed), and the drug impairs patients for hours. Still, it relieves depression for at least several days:  if there’s a choice between being entirely dysfunctional seven days a week or only out of commission for one or two, many people would accept that trade-off.

But while research on ketamine is ongoing, clinical use of the drug in the community remains rare. Fears about abuse continue to run high, though ketamine has never caught on as a major street drug. If the Science paper’s authors are right that ketamine’s effect on depression is a key advance  — and if the drug really holds similar promise for bipolar disorder — patients might want to consider pushing for greater access. Ketamine is off patent, so no drug maker is likely to do so.

Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.

23 comments
CrickrockChannel
CrickrockChannel

 Methylone aka. 3,4-methylenedioxy-N-methylcathinone My theory was to activate the brain areas with bad thoughts while on the drug, so that new 'positive' connections could be built in areas that have less of them because of 'trained' negative connections. The side effects indicate that there must have been a  positive effect, not only a placebo. http://free-coupon.com/

GregMalin
GregMalin

Maia Szalivitz has got the statistics WRONG. An estimated 10% of the U.S. population suffer from Major Depression each year. According to psychiatrists own data 30% respond well to antidepressants and remission rates using standard antidepressants are much lower. So close to 70% do not get much improvement wihin six months. The majority of patients waste many months in trial and error with different drugs. Yet about 5% of the U.S. population suffers from Endogenous depression that is biological and is treatment resistant and never improves. 2% of the U.S. population has Bipolar Disorder and the overwhelming majority do not get any relief from mood stabilizers and suffer terribly from this biological illness. 

A vial of Ketamine 10ml 1 gram costs only $25. And a .05/kg IV dose of about 50mg costs less than ONE DOLLAR. 75% of patients who are treatment resistant get full remission after one IV treatment. It lasts for abut 3 days  and would require two sessions a week. One IV ketamine has proven extremely effective for suicidal patients, OCD, bipolar, BPD. No negative side effects. In 2010 nealry all Drug Companies in the world have shut down their R&D on all psychiatric medications. Yale University officially confirmed in a 2000 study the powerful antidepressant nature of Ketamine. The problem is psychiatry is not based on patient outcome evidence based medicine. Poor outcomes are expected. 

AndiArbeit
AndiArbeit

Methylone aka. 3,4-methylenedioxy-N-methylcathinone did also work very well in a self test. Force yourself to have every thought that you feel really bugs you, while on the drug. It is hard because you will tend to have only positive thoughts. Even weeks after my experiment I discovered that absolutely no negative thoughts was able to drag me down. BUT - and this is funny :) - at the same time I experienced the exactly same kind of 'bruxism' (a light form but anyways) for a few seconds every time I had bad thoughts. Even weeks later! No other side effects :)

My theory was to activate the brain areas with bad thoughts while on the drug, so that new 'positive' connections could be built in areas that have less of them because of 'trained' negative connections. The side effects indicate that there must have been a  positive effect, not only a placebo. 


atramentum
atramentum

There are some people that can't "just look on the bright side", vegetables and vitamins won't help, and pills won't cure.  If they take ketamine AS PRESCRIBED and after trying many other options, and it helps - then that's lifesaving news.

My life has completely changed since I started taking ketamine - and I LOATHE the high feeling at first - but I can't recall a time that I've ever been able to function, be social, and wake up before 4PM every single day.  I wish I could feel better by taking 200mg of zoloft and some therapy, the way so many other people can, but I've found what I need (at least for now) and I'm thrilled about it.

Don't judge it until it's helped you really smile for the first time in years-

Transward
Transward

Over the years I have tried a huge number of anti-depressants.  None did any good.  A small dose of illicit ketamine did, for nearly a month.  I wish I knew how to access The Silk Road. 

Jacqueline Tourville
Jacqueline Tourville

It would be nice to see more research put into natural alternative for depression http://www.womentowomen.com/de... such as exercise, diet changes, testing vitamin D levels, and the use of certain plant-based medicines. Hailing the use of Ketamine for depression just seems like more evidence that we're moving in the wrong direction here. 

Jacqueline

Women to Women Contributor   

sgtbilko
sgtbilko

So now we've got soma, and I guess Blizzard Games is working on the feelies.

O brave new world, that has such people in it!

Jeffrey Alan Craig
Jeffrey Alan Craig

Alcohol does the same thing. Using science-speak doesn't change the fact that the only "discovery" here is that psychotropic drugs alter minds. Ask any illicit drug user's of the last 60 years and they'll tell you; take the blue on for this, the red one for that and the purple one to come down. It's no different when scientists do it, only the language is different. (This is the 5th comment I've written for an article on Time.com, all of them have been removed. Are my views really that inappropriate for here? What's the point of having comments if people can not express their views in them?)

lightandlove50
lightandlove50

Scientist in Europe showed that almost ALL food addiction isRooted in prior abuses,emotional, childhood,mental abuses,depression..etc 

Clinical depression is on the rise and the medications lead to weight gain. Dr. Leaky showed that most depressed people have a problems such as food addiction See here http://foodaddictions.wordpres...

 

Joe Pimpernel
Joe Pimpernel

Well, now we know what the next fad in substances-of-abuse is going to be.

The pattern never changes.

Jeffrey Alan Craig
Jeffrey Alan Craig

"A single dose of ketamine produces relief of depression"

So does alcohol.  Drugs are drugs. Just because some scientists started using science-speak when talking about them doesn't change that fact. Ask any drug user of the last 50 years and he'll tell ya; this blue one works for this, the red one for that, take this purple one to come down, ect.

Lindsay Thomson
Lindsay Thomson

Odd that the article doesn't mention ketamine's use as an intravenous anesthetic...

DoctorFugedy
DoctorFugedy

Having used ketamine as an intravenous, dis-associative, general anesthetic 35 years ago I am reserved in my judgement. Side effects including psychosis and severe nightmares limited use even then. I would rate another new treatment, transcranial direct current stimulation (tDCS), as a monumental breakthrough. tDCS uses a tiny, imperceptible amount of electricity from a portable stimulator to gently facilitate the under-functioning area brain which results in depression. tDCS is effective, safe, easy to do, without any side effects and can be done by the patient at home. In a study published earlier this year, tDCS reduced depression 50% for patients who did not respond to antidepressants.  Targeting a different area, tDCS provides relief for chronic pain  including migraine, fibromyalgia and complex regional pain. Stimulating a different area, tDCS accelerated learning for pilots training on flight simulators in a study funded by DARPA. An Oxford study used tDCS to improve math test scores. tDCS is effective, without side effects and extremely cost effective -the lifetime cost of tDCS is less than the cost of tDCS for an antidepressant for a year.

mtngoatjoe
mtngoatjoe

I can see where this would lead to retreat (or

"vacation") weekends where someone checks into a spa (AKA

"facility) and receives therapy.

 

I also wonder how this would treat people who are in psychiatric

facilities or show up at emergency rooms.

 

Hopefully the research will lead somewhere positive.

DanielleGoodman
DanielleGoodman

my name is danielle. im 27 and have wasted more than half my life (16 years) with MAJOR depression, being too stubborn or hating the side effects of antidepressants. i have hardly any accomplishments, suicidal thoughts for years, can't concentrate for the life of me and bipolar runs in my fmily. i have been having suicidal thoughts daily past 7 weeks, from a tramatic event, and i fear that if i dont get something in my brain that can quickly improve my mood, that it will be too late. i live in southern california. where can i go to get these treatments or buy myself? email me eyecandyart27@yahoo.com

DanielleGoodman
DanielleGoodman

my name is danielle. im 27 and have wasted more than half my life (16 years) with MAJOR depression, being too stubborn or hating the side effects of antidepressants. i have hardly any accomplishments, suicidal thoughts for years, can't concentrate for the life of me and bipolar runs in my fmily. i have been having suicidal thoughts daily past 7 weeks, from a tramatic event, and i fear that if i dont get something in my brain that can quickly improve my mood, that it will be too late. i live in southern california. where can i go to get these treatments or buy myself?

DanielleGoodman
DanielleGoodman

my name is danielle. i'm 27 and have wasted more than half my life (16 years) with MAJOR depression, being too stubborn or hating the side effects of antidepressants. i have hardly any accomplishments, suicidal thoughts for years, can't concentrate for the life of me, and bipolar runs in my fmily. i have been having suicidal thoughts daily, past 7 weeks, from a dramatic event, and i fear that if i don't get something in my brain that can quickly improve my mood, that it will be too late. i live in southern california. where can i go to get these treatments or buy myself? please email eyecandyart27@yahoo.com

AndiArbeit
AndiArbeit

@Transward Install the Tor browser bundle (google). Then search for silk road, enter the site and read the reviews and comments about your desired supplier. 

Also set up a Bitcoin wallet on the standard web, don't use your real name or any real data here. Then buy a Bitcoin with your country currency and transfer it into your new wallet. 

Now you can pay with your wallet when you are on Silk Road with your Tor-Browser. :)

frnz
frnz

@Jeffrey Alan Craig  Alcohol does not do the same thing. I'm bipolar and alcohol often makes me more upset if I am already down. I can personally say that ketamine lifts my spirits within 5 minutes, and does have an afterglow lasting several days with a bright mood and outlook. This is no drug you're probably accustomed to, as it is non-addictive. Too much and you will be uncomfortable, and the aftereffects are nicer than the actual instant effect. Obviously I don't think it would be appropriate for everyone to feel the extra effects that make it popular for other uses, but they are nothing that would be detrimental to completing basic tasks.

JackArtaganMackenna
JackArtaganMackenna

@Jeffrey Alan CraigAlcohol does not relieve depression. I don't think you understand what depression actually is.

Earth_Terminal
Earth_Terminal

@DanielleGoodman wish I had the answer.  It's not an approved treatment, so you can't go to a normal doctor.  Only legal option in the USA is to find a place doing approved research and volunteer, hoping that you're selected for their study.  Sounds hopeful, neh?  

Realistically, your best bet for ketamine in So-cal is to take a trip down to a veterinarian in Mexico.  Wouldn't try to smuggle any back into the US, but you might be able to talk a guy into doing a proper IV treatment if you brought all the literature you could find on it.  Hell, that could become a side business for the guy.

But the safe bet is to order MXE from a website that sells research chemicals.  It's not illegal to purchase or possess since it's not a scheduled substance or subject to the Analogue Drug Act (as ket is sched 3, and the act only covers sched 1 and 2 substances).  So, yeah.  Do some research, buy a scale that can handle milligrams... and remember to never ingest anything not approved by the FDA.