Ketamine is perhaps best known for being a popular recreational drug and a powerful medical anesthetic, but an increasing body of research showed that the compound may also be effective in treating psychiatric disorders such as depression.
All were treated with anti-depressants throughout the trial, with half given esketamine - part of the ketamine molecule - twice a week for four weeks. The researchers looked at effects at four hours after first treatment, at 24 hours and at 25 days.
"In just a matter of hours" participants in the ketamine test group and their doctors "measured a significant improvement in symptoms of patients classed as being at high risk of suicide", says The Independent.
The results of the study support nasal spray esketamine as a possible effective rapid treatment for depressive symptoms in patients assessed to be at imminent risk for suicide, according to the authors. Esketamine is probably not a long-term treatment, because it has side effects, such as causing hallucinations and feelings of being detached from surroundings. If esketamine wins FDA approval, a system would be needed to ensure it's used properly, because it can be addictive. It was funded by Janssen Research and Development, LLC.
However, the researchers, as well as members of the AJP Editorial Board, acknowledged the unsafe potential for abuse that surrounds the drug. That caution is also the focus of an accompanying AJP editorial also published online today.
If approved for use on the NHS, Stone said, the spray "would be aimed at people with severe depression as a second or third line of treatment if other drugs haven't worked", including as a potential alternative to electroconvulsive therapy.
While it is the responsibility of physicians to provide a suicidal patient with the fullest range of effective interventions, the AJP Editor's note, "protection of the public's health is part of our responsibility as well, and as physicians, we are responsible for preventing new drug epidemics". In addition, to date, clinical ketamine trials have been small, and the researchers note that future studies will need to include a larger pool of participants to validate these early findings.
"The interesting U.S. study confirmed the findings from successful studies into intravenous ketamine", said Dr James Stone from Royal College of Psychiatrists, "The main reason for its significance is because this is being developed by a drug company and it's potentially quite likely that this medication might become available as a treatment available on the NHS for depression".
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