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 Marcia Purse

Exciting News: Ketamine Enters Clinical Trials for Antidepressant Use

By February 10, 2012

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Depression ReliefAs I first reported in August, 2010, almost 3/4 of patients who were given intravenous ketamine in a small study had rapid relief from their treatment-resistant depression - the median time was just 40 minutes. This was a very small study, with 17 patients who received ketamine and 16 receiving placebo. But now formal clinical trials are being conducted to see whether ketamine, best known as the club drug "Special K," is safe and effective enough for use as an antidepressant.

However, it's important to know that: In spite of the small group of patients in the original study, the results were strong enough to make headlines: 71% of those receiving ketamine had relief from depression, and only 1 in 16 of those receiving the placebo reported improvement. One in each group developed manic symptoms. Dissociative symptoms were the most common side effect and did not continue.

Ketamine, widely used as a large animal tranquilizer and as an anesthetic, has also become a drug of abuse. It can cause hallucinations, respiratory distress, blood pressure spiking, and confusion, among other things, so it's a drug that should be used only under a doctor's care and with close monitoring.

The headlines don't mean you can rush out and ask your doctor for intravenous ketamine to ease your depression. The original study's results, were extremely promising:

  1. The patients' response to ketamine appears to validate recent research that has targeted a particular brain system as being involved in bipolar disorder.
  2. The results certainly were significant enough to push forward more and bigger studies to confirm them.
  3. If larger studies confirm the beneficial effect of ketamine, it is likely that there will be a strong research effort to find ways to prolong the antidepressant effects.
When I first reported on ketamine, I said, "This small study could be the start of something big." Looks like it was.

Clinical trials on Ketamine are recruiting participants:

As you can see, people with bipolar disorder are not eligible for all these studies, but you can pass the information along to those you know with serious major depressive disorder.

Sources:
Archives of General Psychiatry
LiveScience

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Comments
August 10, 2010 at 9:05 am
(1) Richard Jarzynka says:

During a severe episode of depression, I would not think twice about risking the listed side effects of a main-line dose of ketamine. If a shot in the arm – or elsewhere – could relieve that pain in 40 minutes, it would be well worth any temporary hallucinations, blood pressure spike, confusion, dissociation, or respiratory distress.

August 10, 2010 at 12:40 pm
(2) Nikki says:

Oh, RIGHT. Give BP patients intravenous doses of “Special K” (its recreational moniker) to alleviate a depression episode. I don’t care how fast it works – it’s no secret that an alarmingly high percentage of BP folks already self-medicate, and I can NOT foresee this being a long-term solution. There’s just too high of risk for addiction issues. I guess if that doesn’t concern you, than this is your answer ((but who are we kidding?) *Laughing* At least you could bill your insurance for this fix.

April 10, 2011 at 3:17 am
(3) shawn says:

Nikki, you sound like a psychiatrist. Have you ever checked out the consequences of standard bipolar meds? There is no winning situation with this disease.

August 10, 2010 at 3:21 pm
(4) Ashley says:

All I know is that if it works, I’m so excited! Yay! It would be nice to get a break!

August 11, 2010 at 8:58 am
(5) wade says:

You have a problem, Nikki. The results of the study are promising. And to expect people suffering from drug resistant, severe depression to not get exited about this thing is … well, unreasonable.

Good for the results and there is hope for a lot of us/you. Up with positive thinking, and down with the the old crabs like this one above.

August 11, 2010 at 8:59 am
(6) Richard Jarzynka says:

My insurance would have saved tens of thousands of dollars if a shot of ketamine had kept me from being hospitalized for bipolar 7 times for a total of 5 months.

I would not have needed ketamine to be a “long-term fix.” I would only have needed it to keep me from the verge of suicide until the more traditional treatments took effect.

Addiction issues can be addressed specifically with each individual. If a patient has a history of addiction, precautions may have to be taken with ketamine and there would be some people for whom the risk of addiction would be to high. I have no history of addiction of any kind. I take my prescribed medications and nothing else – not even a beer since 1994.

August 12, 2010 at 11:24 am
(7) Norma says:

Yay! Anything that is this promising should be investigated further. It gives me hope for the future and that is something we all need.

August 24, 2010 at 6:22 am
(8) Lynn says:

I am with you Wade! My son as severe depressive episodes with his BP and just the fact that they are working on “any” sort of solution is music to my ears. To see any kind of relief for him would be a long awaited answer to my prayers!

August 31, 2010 at 9:04 am
(9) Eric says:

Wade is right about Nikki. Unless Nikki is smarter than all those Yale professors.

October 7, 2010 at 12:37 pm
(10) John Bodie says:

If it is working, it should be clinicaly trested further. Most all drugs have addictive properties. Lets be VERY careful, but if it helps it might be a new tool in the battle.

February 11, 2012 at 2:03 am
(11) sdf says:

People like Nikki who don’t suffer severe depression need to well, stfu and mind their own business. And Stop interfering with the hopes of long evasive relief for many depression sufferers, since it’s evil.

It’s really good news that this caught on. Other drugs of promise that were associated with drugs of abuse were shoved under the rug in the past, as cowardice let public stigma and stereotypes win.

The side effects of Ketamine sound trivial compared to depression itself. Certainly if it’s severe. Already many depressed have gone through weird withdrawal effects from Paxil and others. Never mind, if you want to talk side-effects, look at other meds. Lamisil for fkn toe fungus can cause rash, liver damage, depression, and often does, just read its user reviews. Yet as soon as a drug is associated with recreational use, it “must” be worse than everything else, ridiculous.
Depression kills. Toe fungus does Not. Yet where are the Nikkis commenting against Lamisil? Is a destroyed liver better than merely possible, and only temporary hallucinations for something that for the first time works against a crippling disorder? Those that say yes, may want to look into meds for themselves.

February 11, 2012 at 10:58 am
(12) jed says:

Where do people with refractory depression go in the USA to get Ketamine treatment?

February 11, 2012 at 11:12 am
(13) Marcia Purse / Bipolar Disorder Guide says:

Jed, Ketamine isn’t available yet. It has to go through clinical trials, and the way I read this, it’s only in Phase I. It will be a while before it’s FDA approved and can be marketed.

February 11, 2012 at 1:45 pm
(14) crazywilde says:

I don’t see how ketamine will help at all!!! U guys have no idea. Before I was diagnosed with bipolar I used to go clubbing and use ketamine 3days a week. It never helped my depression in fact it made it worse. It sent me crazy and psychotic untill I had a line of ket then it made u live in your head in what is called a k hole. Completly f*ks up your judement and abilty to do normail daily tasks

So go on try it and see if its worth the side effects!!! Cause its not!!!

February 14, 2012 at 12:01 pm
(15) Jill says:

NPR had a program on Ketamine and the researcher said Scolapine (anti-nausea med) has also had much success with depression without as severe side effects. Is anyone familiar with Scolapine or maybe it was Scolapamine and have you tried it? Thanks!

February 15, 2012 at 7:03 am
(16) Tamara says:

I have been in absolute misery and even suicidal during an extreme bipolar depression, and would do anything for some (almost) instant relief. If a patient arrived at the ER in extreme physical pain, that person would certainly be given pain relief meds. I would say that ketamine should be used carefully, and only for severe cases, but definitely could save a life.

February 17, 2012 at 8:02 pm
(17) Marg says:

Can someone explain what ketamine is? Is it a drug? A vitamin?

March 25, 2012 at 1:40 pm
(18) Jeff says:

All – The consensus of these comments is for the bipolar community to move forward with further ketamine studies. And some (like myself) would like to try it before (if ever) it gets out of clinical studies. My understanding is research on drugs like ketamine is very limited because Pharma doesn’t participate. They can’t make money off of it so they don’t bother to do the expensive research. How do we get around this?

Jill – I wrote a post about scopolamine (http://bipolar-living.blogspot.com/2012/02/scopolamine-for-my-bipolar-depression.html) last month. I tried it with an old patch (exp. 2001) and didn’t experience any effects, good or bad. I intend on trying it again this year.

April 16, 2012 at 11:24 pm
(19) sara says:

I’m a depressive, and I’ll wholly admit.. don’t leave special K in my hands, I’ll abuse and never come back from it. How can psychiatrists trust other depressives not to do the same? Special K is a club drug, and a ‘quick fix’ is the wrong way to alleviate depression. Plus, the Withdrawal effects are most probably terrible.

June 12, 2012 at 10:21 am
(20) Sally says:

For those concerned about abuse, as currently researched, ketamine is given at 1/4 the anesthetic dose (which is far lower than the clubbing dose), given intravenously (not snorted) and never left “in your hands,” as sara was concerned. Appropriate dosing and intervals are being developed and it is administered on an out-patient clinic basis. Nobody gives a bottle and sends you home with it.
Given in the current doses and at the current intervals, the short-term safety of ketamine is established over decades of anesthetic research. It is the long-term for which we must be concerned, and how to get long-term effects. One case study had one patient respond long-term to once-every-three weeks maintenance dosing. If this interval or one like it pans out for other people, it should cause fewer withdrawal effects than some SSRI’s and SNRI’s.

December 27, 2012 at 5:49 pm
(21) cheryl says:

I have been on many antidepressants for the past 15 years. You dont know how addictive those drugs are unless you have had to go through withdrawals because they are not working. 2-3 weeks of absolute mental anguish. I would love to have something that works. If you dont have the knowledge and the pain of depression, please keep the comments to yourself.

January 31, 2013 at 12:11 am
(22) kay says:

does anyone know anywhere near phila where they would conduct studies for this drug ketamine

March 28, 2013 at 11:41 am
(23) Lisa says:

If you really are interested, NIH is still recruiting for Ketamine trials. I am scheduled to participate in April, but I’m having second thoughts. 2- 3 months is a long time to be an inpatient–especially since I will be 3000 miles away from any friends or family who could visit me. In my desperation, it sounded like hope, but the fact is they will only administer the Ketamine once, and then watch what happens. The antidepressant relief usually only lasts a week. For that week of relief, I will have to endure months of blood tests, MRI’s, and any other poking and prodding they want to do. I will have to go off all other meds, and stay in the hospital so they can document my body’s reaction to the Ketamine. It’s a pretty high price to pay for maybe one week of relief. They pay for your plane ticket, but other than that, there is no compensation for those 3 months. There may be other trials going on somewhere, but that’s the only one I know of that is still recruiting. You can always check for new studies at
http://www.clinicaltrials.gov . Good luck!

January 18, 2014 at 6:02 am
(24) BP Dad says:

My son is receiving ketamine in a nose spray. He is a teenager with BP. He takes it every three days. BP symptoms are gone! No more fear, aggression, sleeping problems, food craving, cursing, mania, or OCD tendencies. It is amazing!!!!!!!!! We have been on ketamine 3 months. We have tried everything.

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