Cheap ketamine injections have been shown to help patients with severe depression when other treatments have failed.
Ketamine is a dissociative anesthetic used medically for induction and maintenance of anesthesia.
It is also used as a treatment as a pain management tool and as a recreational drug. Ketamine is a novel compound that was derived from phencyclidine in 1962, in pursuit of a safer anesthetic with fewer hallucinogenic effects.
A study in Australia found that one in five patients achieved total remission from their symptoms after a month of twice-weekly injections, and a third said their symptoms improved by at least 50%.
“For people with treatment-resistant depression – so those who have not benefited from different modes of talk-therapy, commonly prescribed antidepressants, or electroconvulsive therapy – 20 per cent remission is actually quite good,” said lead researcher Professor Colleen Loo.
The research, led by a team from the University of New South Wales Sydney and the Black Dog Institute, Australia, was a double-blind trial, meaning neither those administering or receiving the injections knew whether they were getting the ketamine or a placebo.
One in five patients treated successfully for depression
“We found that in this trial, ketamine was clearly better than the placebo – with 20 per cent reporting they no longer had clinical depression compared with only two per cent in the placebo group,” added Professor Loo.
“This is a huge and very obvious difference and brings definitive evidence to the field which only had past smaller trials that compared ketamine with placebo.”
During the course of a month, 179 participants received two injections a week in a clinic, where they were monitored for around two hours while any acute dissociative or sedative effects wore off.
Unlike previous studies, the placebo was a mild sedative, midazolam, to improve treatment masking – if only saline was used, participants may have guessed they were given the placebo due to the lack of any side effects after administration.
“Because there are no subjective effects from the saline, in previous studies it became obvious which people were receiving the ketamine and which people received placebo,” said Professor Loo.
“In using midazolam – which is not a treatment for depression, but does make you feel a bit woozy and out of it – you have much less chance of knowing whether you have received ketamine, which has similar acute effects.”
The study, published in the British Journal of Psychiatry, asked participants to assess their mood at the end of the trial and one month later.
In a second departure from previous studies, the trial included those who had previously received electroconvulsive therapy (ECT).
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