Ketamine found to offer hope as last-resort treatment for depression

pharmafile | April 6, 2017 | News story | Research and Development Ketamine, University of Oxford 

Researchers from the University of Oxford have conducted a six-year study looking into the potential therapeutic effects of ketamine as an antidepressant. The drug is mainly associated with its illicit use as a party drug but now researchers are trying to break the taboo to highlight the potential therapeutic uses.

101 people were involved in the study, of which 42 reported improvement to their condition whilst being administered the drug. Each of the individuals involved in the study had not responded the treatment with conventional antidepressants and were treated with ketamine to determine whether it could be considered as a ‘last resort’ treatment.

Unlike in its illegal use as a ‘party drug’, the patients were given doses in low levels, in milligrams. The treatment consisted of one 40-minute intravenous infusion which was followed up by twice-weekly oral doses. Depending on the patient, this could be followed up with a further two infusions.

Dr Rupert McShane, a consultant psychiatrist at Oxford Health NHS Foundation Trust and lead researcher, said: “I have seen ketamine work where nothing has helped before. But ketamine is a drug not a miracle, and maintaining the benefit is a challenge. So far, the only way we have found to maintain the benefit is repeated dosing. We think that patients’ treatment should be in specialist centres and formally tracked in national or international registries. This will help us to pick up any safety or abuse problems with longer term use, and narrow down what dose, frequency, route and duration of treatment works best.”

This recommendation would create a licensed and regulated form of ‘ketamine clinic’ that are beginning to appear, unregulated, in the US and Australia. When used in a controlled environment, the drug is relatively safe. However, in those that are not qualified or those that are using the drug recreationally, there is serious potential for harm. There have been those that have abused the drug that have suffered serious bladder problems.

Of the 101 people involved in the trial, one individual stopped because of bladder complaint, there were some issues with reports of poor memory and five individuals had to stop infusions due to feeling faint.

In the study, published in The Lancet Psychiatry, was supplemented by commentary from other experts in the field. In this, it was stressed that research into ketamine use as a therapy for depression is still in its early stages and that there are still gaps in scientific knowledge. However, both the study and commentary called for more studies and more research to be conducted into the potential benefits of the drug.

Ben Hargreaves

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