Mental Health

Ketamine Can Ease Depression, Reduce Suicidal Thoughts: Study

Findings were published from the first study by a drug company to examine ketamine as a treatment option for depression. The study, conducted by Janssen Research and Development and the Yale School of Medicine, was published in the American Journal of Psychiatry (AJP) on April 16. It was funded by Janssen Research and Development, LLC.

Ketamine is an anesthetic used on animals as well as human beings in the event of a relevant medical procedure. But the sedative has also been abused by partygoers, enough to be considered a "date rape drug" alongside Rohypnol.

The double-blind study was conducted on 68 participants (at imminent suicide risk) who were randomly assigned to one of two groups. Patients in one group received the standard treatment along with ketamine in the form of a nasal spray known as esketamine. Patients of the other group were given a placebo spray, designed to not have any effect. Treatment with antidepressants was continued for all the participants throughout the trial.

The researchers compared the effects at four hours after first treatment, at 24 hours and at 25 days. Compared to the placebo group, the results showed a major improvement in depression scores and reduced suicidal ideation in the ketamine group at four hours and at 24 hours after the first treatment. At 25 days, the effects of the ketamine spray had stabilized, being no more effective than the placebo treatment.

The rapidity of the ketamine treatment is of particular interest as most antidepressants take more than a month to become fully effective. The research team stated the results of the phase 2 study provide a strong case for the nasal spray esketamine to be used as a fast-acting and effective treatment for depressive symptoms in patients assessed to be at imminent risk for suicide.

However, the researchers, as well as members of the AJP Editorial Board, acknowledged the dangerous potential for abuse that surrounds the drug. In an accompanying editorial published along with the study, reports of abuse (including cases of prescribed ketamine) were noted. Previous studies have also acknowledged that the drug could lead to hallucinations, cognitive problems, nausea and other health complications. The nasal spray will be required to undergo phase 3 trials before potential approval by the FDA.

Recommendations and plans have been put forward for further research to understand the potential for ketamine abuse during the third phase of trials. This could include monitoring levels of craving and possible ketamine use from other sources. "Protection of the public’s health is part of our responsibility as well, and, as physicians, we are responsible for preventing new drug epidemics," said Dr. Robert Freedman, the current editor in chief for the AJP.

The editors added that steps should be taken to make sure ketamine-based treatment will "continue to be available to those with need, while the population that is at-risk for abuse is protected from an epidemic of misuse."