Can Ketamine Treat Depression? | Big Think

Depression is a very serious clinical problem. Work has been going on for many years to discover better treatments for depression. Most depression treatments, medicine I'm talking about, take weeks to months to work, like Prozac and Paxil. And that's been a problem. There’s a delay, and they also don't work in everybody.

So my research team has been working for many years to discover better treatments, better medicine treatments for depression. We have recently found that ketamine is a rapidly acting anti-depressant. Now, some people know ketamine as a recreational drug of abuse called Special K. But we have found that it has potential for the treatment of depression that has not responded to traditional anti-depressant treatments and that it works faster. It can work within several hours.

So we're working on it. It's not yet approved, so it's now at the level of research. But it's now been found by research groups all over the world that ketamine works quickly, and that the response can at least be maintained for several weeks. So now we're working on how to maintain the response for much longer than that and to test out its safety for long-term treatment.

But at a minimum, it's broken new ground because ketamine works differently than other anti-depressants. We now know that there are methods to get people better from serious forms of depression very quickly. One reason that scientists say that the ketamine findings are a major advance in the treatment of depression is that ketamine works very differently than other anti-depressants.

The anti-depressants that are now generally available work through monoamines neurotransmitters like serotonin and norepinephrine. That's how Prozac, Paxil, and Zoloft, for example, work; they block the re-uptake of the neurotransmitter serotonin. Ketamine does not work through that mechanism. Ketamine works through another neurotransmitter system called the glutamate system, and initially, its effects are modulated by blocking the NMDA glutamate receptor.

So we know that's part of the way that ketamine works. But researchers now in labs around the world are probing more deeply about how ketamine can start by working through the glutamate system and then cause other changes in brain function that result in that anti-depressant response. So that is work that is now occurring. But we do know, at a minimum, that it works very differently than the available anti-depressants.

As I mentioned, ketamine is a recreational drug of abuse, and we have to be concerned about that in any development of ketamine that leads to formal approval by the FDA and ultimately becomes generally available for the treatment of depression.

So the clinical studies that are now being undertaken by major pharmaceutical companies are studying intranasal forms of ketamine, and they will watch for any signs of abuse by patients. Probably, the way ketamine will be distributed will be on a dose-by-dose basis. And for patients that have a history of substance abuse, it may not be the appropriate drug to use.

But I personally feel that ketamine is well tolerated in the dose that we use for the treatment of depression and that if longer-term studies show that it's safe and that it's not abused, it could really revolutionize the treatment of depression for patients who have serious depression that is treatment-resistant to the available treatments.

So it'll be used for a very certain group of people who are really suffering.