AOK for Special K?

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Screen Shot 2014-12-10 at 3.01.06 PMIn the always-uphill battle against depression a vicious and life-threatening disease that is typically caused by a malfunction of certain neurotransmitters or receptors in the brain any help is welcome.

The fact that the help may be coming from an old drug, which has been used to anaesthetize cats and as a recreational party drug is irrelevant. Current treatments for depression have two major shortcomings, and ketamine a/k/a Special K may represent a badly-needed addition to the arsenal of current antidepressant drugs.

Although modern antidepressant medications, such as Paxil, Zoloft, and Cymbalta represent a big advantage over older drugs, they are far from perfect. Two of the principal drawbacks for serotonin selective reuptake inhibitors (SSRIs) are that patients react very differently to individual drugs, even within the same class.

Perhaps worse, is that the response time the amount of time it takes for the drug to begin to work, or reach its maximum benefit ranges from 2-6 weeks. During this time, not only will depression sufferers be untreated, but since side effects are common with all of these drugs, they may feel even worse.

Given the long induction period, along with the hit-or-miss nature of these drugs (most patients will have to try more than one drug to find one that works for them), it is not uncommon for victims of depression to have to wait months for any relief.

Ketamine, although itself imperfect, may be the answer to these problems, at least in some cases. The drug acts by an entirely different mechanism from the SSRIs, and this may add a powerful new weapon to the arsenal of antidepressant therapies.

According to an article in today s New York Times, small studies are being conducted in major medical research centers, such as Yale University, and Mount Sinai Hospital, where there is some evidence that ketamine can melt away within hours, rather than the weeks typically required for a conventional antidepressant.

Since ketamine is FDA-approved as an anesthetic, it can be used off-label for any other purpose. This does not make it perfect, however.

ACSH s Dr. Josh Bloom explains, Almost all psychotropic drugs have multiple physiological effects, since they usually affect more than the target receptor. This holds true for ketamine. Part of its allure as a street drug is that it is a hallucinogen fine if you want to get high, but not so great if you want to simply feel better. Other side effects include sedation, amnesia, and rarely, permanent brain damage or even death.

There is ongoing research to find a ketamine-like drug that retains its rapid antidepressant while minimizing side effects. If this can be accomplished it would represent a badly needed new paradigm in the treatment of this awful disease.