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Drug may quickly lift depression, study says
Ketamine, an anesthetic also used illegally as the club drug Special K, has the power to lift stubborn depression within hours, instead of the weeks it typically takes prescription antidepressants to kick in, a new federal study suggested yesterday.
Researchers and drug companies have been working for years to develop faster-acting antidepressants, but despite some promising clinical trials, none has made it to market yet. The preliminary study on ketamine, involving just 18 people, could help lead to antidepressants that work much faster than those now available, researchers say.
“The public health implications of being able to treat major depression this quickly would be enormous,” Dr. Elias A. Zerhouni, director of the National Institutes of Health, said in a statement.
The weekslong gap between the moment when a depressed person starts taking antidepressants and when the drugs finally kick in is a notoriously risky one. In the initial days, patients may paradoxically feel more anxious or depressed and may experience such side effects as sleep disturbance and, rarely, an increased urge to commit suicide.
“It is this very dangerous period that lasts at least two weeks and likely closer to 4 to 6 weeks,” said Dr. Matthew W. Ruble, associate training director of adult psychiatry at Cambridge Health Alliance.
Sometimes stimulants can help bridge the gap, he said, but often the best a psychiatrist can do is monitor the patient carefully and work on establishing a good therapeutic relationship while waiting for the drugs to take effect.
Ideally, antidepressants would kick in “within hours, like you have for any other form of pain,” said Dr. Thomas R. Insel, director of the National Institute of Mental Health.
Researchers cautioned that ketamine, which they gave at doses far lower than those used by club users, should not be abused and is far too experimental to be used by psychiatric patients.
“It’s not ready for prime time yet,” said Insel, whose agency funded the research. But if the quick antidepressant effect of ketamine is borne out in future studies, “it would be just terrific,” he said.
The study found that patients given a single intravenous infusion of ketamine began to feel their depression lift within two hours and that after a day, 71 percent reported a major improvement in mood. A control group that received an infusion containing only a placebo showed no improvement.
The patients, who suffered from treatment-resistant depression and had already tried an average of six different antidepressants, had no serious side effects. A week after the single injection, when researchers stopped observing the subjects, 35 percent were still feeling better.
“To my knowledge,” Insel said in a statement, “this is the first report of any medication or other treatment that results in such a pronounced, rapid, prolonged response with a single dose.”
Source : http://www.boston.com/yourlife/health/mental/articles/2006/08/08/drug_may_quickly_lift_depression_study_says/