A new pill that releases ketamine slowly could treat people with severe depression without the psychedelic side effects of the commonly abused drug, early research results suggested on Monday.
Ketamine was first developed in the 1960s as an anesthetic and its hallucinogenic and dissociative effects led to it becoming a party drug called “Special K”.
However, growing research has shown that ketamine is effective for roughly a quarter of people with depression who see little benefit from standard antidepressants.
In many countries, ketamine has been prescribed for depression for years.
American billionaire Elon Musk told CNN in March that he regularly takes a small amount of prescription ketamine because it “helps to get someone out of a negative state of mind.”
The drug has long been administered intravenously in clinics, but recently a nasal spray containing a derivative called esketamine has gained popularity.
Both drugs can cause side effects, such as dissociation, high blood pressure and an increased heart rate.
There are also concerns that the drug’s medical use could lead to abuse.
The pill described in the magazine Naturopathy It takes more than 10 hours on Monday to be broken down in the liver, lead study author Paul Glue told AFP.
“The really interesting feedback from patients is the lack of side effects: no euphoria, no dissociation,” said the researcher at New Zealand’s University of Otago.
“I don’t think these tablets will appeal to people who abuse ketamine.”
Alternative to electric shock
The phase 2 study involved more than 270 people with depression who had tried an average of four different antidepressants.
The study found that more than half of the participants who took the ketamine pill went into remission from their depression, while 70 percent of participants in the placebo group relapsed after 13 weeks.
Julaine Allan, a mental health and addiction expert at Australia’s Charles Sturt University, who was not involved in the study, praised the trial and stressed that more research is needed.
Ketamine doesn’t work for everyone, and the “positive effects can wear off over time,” she told AFP.
Michel Hofmann, a psychiatrist at Geneva University Hospital, said there is “real enthusiasm” in the medical community about ketamine’s potential treatment options for depression.
“For patients who do not respond to conventional medications, ketamine offers a way to avoid electroshock therapy,” he told AFP.
This last resort treatment, which involves sending electrical current through the brain, has been proven to be effective.
But it can cause memory loss, and some patients fear the procedure after seeing movies about it, such as “One Flew Over the Cuckoo’s Nest.”
Fears of ‘opioid-like crisis’
Some psychiatrists are still hesitant to prescribe ketamine for depression because they fear their patients will misuse the drug.
Last year, “Friends” actor Matthew Perry became the latest high-profile death from a ketamine overdose.
US police are investigating how Perry obtained the doses that caused his death; he reportedly had not had a supervised infusion session for several days.
One potential benefit of fast-acting ketamine that has emerged from previous research is that it may help patients who are considering suicide.
But there is “a plausible concern that the widespread use of ketamine could trigger a new opioid-style crisis,” Oxford researcher Riccardo De Giorgi said in a 2022 BMJ editorial.
By ridding ketamine of the side effects that some partygoers are waiting for, the slow-release pill could alleviate some of these concerns.
There were still some side effects from the pill, the most common of which were headache, dizziness and anxiety.
More research, including phase 3 trials, is needed before the drug can be reviewed by national medicines agencies, meaning it will be at least two or three years before patients could potentially get access to the pills, Glue said.
More information:
Paul Glue, Ketamine Extended-Release Tablets for Treatment-Resistant Depression: A Randomized, Placebo-Controlled Phase 2 Trial, Naturopathy (2024). DOI: 10.1038/s41591-024-03063-x. www.nature.com/articles/s41591-024-03063-x
© 2024 AFP
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