Two new studies suggest the psychiatric benefits of ketamine treatment may extend beyond just the targeting of depression. The research demonstrates ketamine may be helpful in targeting both anxiety- and substance abuse-related depression.
Although ketamine is a relatively old drug, originally developed in the 1960s as an anesthetic, over the last decade a growing body of research has affirmed its unique, and rapid, antidepressant effects. Both the science and anecdotal evidence has become overwhelming, it is now clear that ketamine acts powerfully and rapidly as an antidepressant and is able to treat even the most difficult cases of depression. Northwest Ketamine Clinics, with locations in Seattle and Bellevue, is the leading clinic in the region. We’ve successfully treated hundreds of patients and remain the most respected and lowest priced ketamine provider in the area.
Much is still unknown about the use ketamine actually is for depression. Through research and clinical experience, we are quickly becoming able to pinpoint the proper dose for each patient and work with the patient to increase the success rate and lengthen the times between “booster” infusions. Two newly published studies are adding to our knowledge about ketamine’s psychiatric uses, adding weight to the drug’s burgeoning new potential.
The first study, led by a team from Massachusetts General Hospital and Harvard Medical School, set out to study how effective ketamine is at treating patients with anxiety-based treatment-resistant depression. This is an important question to resolve, as many traditional antidepressants do not consistently improve anxiety-based symptoms in cases of major depression.
The study took 99 subjects with treatment-resistant depression, half of whom suffered from high anxiety and half of whom displayed no anxious symptoms. The study randomly administered subjects either one of four different intravenous ketamine doses or midazolam, a general sedative that could serve as a control.
As well as demonstrating ketamine’s novel antidepressant qualities, the study revealed the drug worked equally well in both anxious and non-anxious subjects. This suggests that ketamine’s antidepressant effects are uniquely effective across different types of treatment-resistant depression, something that cannot be said for many major antidepressant drugs.
“In contrast to reports from monoaminergic antidepressants, our data suggest that patients with anxious depression respond equally as well to ketamine compared to those with non-anxious depression,” write the researchers in the published study.
The second new study comes from a team at Yale University School of Medicine. This research investigated whether ketamine could be effective in treating addiction-related depression when administered in tandem with naltrexone.
A study in 2018 offered a small but significant finding, revealing that ketamine was ineffective in treating depression when administered alongside naltrexone. These results were important because they suggested that part of ketamine’s antidepressant effects may be related to the activation of opioid receptors, which would mean long-term ketamine use may potentially result in problems with addiction, something that many researchers have long argued against.
Naltrexone, an opioid receptor blocker, is often administered effectively to combat serious substance abuse problems, so if it rendered ketamine ineffective then that would cast doubt on much research into how ketamine actually works to reduce symptoms of depression. The new Yale research was small, with a sample of only five patients, but its results strongly suggest ketamine and naltrexone do not cancel each other out.
All five subjects suffering from alcohol use disorder and depression displayed significant depressive relief from ketamine dosages despite long-term naltrexone consumption. Senior author on the study, John Krystal, says although larger studies still need to be completed the research does suggest ketamine and naltrexone may be a complementary combination that helps treat substance abuse and its related depression.
“[The results] raise the possibility that for people who have depression complicated by substance abuse disorders, the combination of ketamine and naltrexone may be a strategy to explore in the effort to optimally treat both conditions,” says Krystal.
We are still in the early stages of research regarding depression and substance abuse and large studies are still needed. This new study only consisted of five subjects, and the prior research linking ketamine to the opioid system was generated from just 12 subjects. We are still in somewhat uncharted territory regarding ketamine’s mechanistic effects of the brain and larger studies are needed. But the Yale research should assuage some fears that ketamine may be, “merely another opioid in a novel form.”
The ketamine anxiety study was published in the journal Depress Anxiety.
The ketamine naltrexone study was published in the journal JAMA Psychiatry.
Source: Yale News