Ketamine: The New Wonder Drug August 25, 2013Posted by Crazy Mermaid in Depression, Medication, Suicide.
Tags: Depression, Suicide
At our recent NAMI Washington conference in Ellensburg a few weeks ago, the most exciting thing I heard about was a drug called ketamine. It’s a drug that relieves severe depression symptoms almost immediately. It would save the lives of the 35,000 people who die of suicide in the United States each year and substantially improve the quality of life of those who suffer from depression.
But with all of the promise this drug elicits, the problem is that there aren’t enough studies to warrant adding “antidepressant” to its list of “on-label” uses. The best we can do right now is administer it as an “off-label” use at hospital emergency rooms or mental hospitals, which is where suicide wanna-be’s show up, or at psychiatrist offices, where people with severe depression seek help.
Ketamine has historically been used as an anesthetic in humans and animals, and its antidepressant quality was accidentally discovered when people undergoing surgery experienced a lifting of their depression upon awaking or shortly thereafter. The antidepressant effect was traced to ketamine.
Further studies, though limited in quantity, confirmed that 70% of people given ketamine injections experienced substantial relief of their depression symptoms after administration of this drug- some in as little as 2 hours after the drug was administered. That’s a world away from the 4 to 8 weeks needed for a traditional antidepressant to work. It can mean the difference between someone committing suicide and staying alive. Or it can mean a substantial improvement in quality of life for those suffering from depression.
One of the problems with getting enough documentation in order for the US Food and Drug Administration to approve ketamine as an antidepressant is that the drug is an old one, with an expired patent. That means that no drug company is willing to spend the money necessary to finance drug studies to prove the drug works as an antidepressant.
Although the cost of an injection seems like a lot of money to us, (about $900) that’s not enough money to entice drug companies to spend vast sums necessary to administer the necessary testing. So, instead of the traditional path through drug companies, testing will have to be done through grants from the National Institute of Mental Health or other bodies like that, with no financial interest in selling the drug. The best we can hope for from the drug companies is an isolation of the mechanism that works in ketamine, and a new drug developed from that mechanism. That could take years. In the meantime, its antidepressant use must be limited to “off-label”.
One of the challenges associated with ketamine is that it has an unfavorable image as a “club drug”, a drug used by young people frequenting clubs to get high. When used in large doses, it induces an out-of-body experience, something drug users are attracted to. This use impacts the politics of the drug, since no one wants to be caught developing a drug like LSD.
Since I haven’t seen him since my conference, I haven’t had the opportunity to talk with my psychiatrist about this drug. That conversation will be interesting. Stay tuned.