A loss of hope is a classic symptom of depression. For many patients, hope has been restored with medical innovation. Drugs and therapies have been developed over the decades that help to balance or trigger serotonin, norepinephrine, and other neurotransmitters. But for one-third of depressed patients, the medications are not sufficiently effective, further diminishing any hope of returning to normal.Patients may receive electroconvulsive therapy or other intensive treatment options. Yet too often, the last resort is suicide.
While many companies have wound down their quest for a new drug over the last few years, researchers at the National Institute of Health weren’t ready to throw in the towel.In 2013, ketamine, a drug commonly used for anesthesia, was studied for its ability to target and inhibit the action of N-Methyl-D-aspartate (“NMDA”) receptors of nerve cells. The results were overwhelmingly favorable. Initial studies indicated that 70% of Treatment-Resistent-Depression (“TRD”) patients saw an improvement in symptoms within 24 hours of being injected with a low dose of ketamine. These rapid timelines raised eyebrows in the industry, as typical treatments take nearly a month to evaluate the efficacy. For the first time, there was hope for the severely depressed patient that requires more rapid response or has failed medication options.
The studies triggered the FDA to grant Fast Track Status to the development of a new NMDA-receptor-targeting medications based on the ketamine profile. This includes esketamine, a drug in development that would lower the ketamine dosage and be administered through a nasal spray. Esketamine received breakthrough status by the FDA in August of 2016, further enhancing the probability that these new drugs will be available to patients in 2017.
With nearly 43,000 suicides a year in the US and growing, the need for effective treatment has never loomed larger. In the medical community, hope has never been higher.
Where Are They Now
In 2018, Ketamine for the treatment of depression is still considered off-label use. The drug is currently only used in the most severe cases. The treatment, however, is still of great interest to specialists that have tried everything with their patients. The long-term efficacy of ketamine for TRD has yet to be investigated, but more research in 2018 may shed light on the controversial indication.