Is Special K the Next Prozac?
Since the late 80’s when Prozac was introduced, SSRIs have been the default treatment for depression, but researchers are attempting to develop a more effective treatment using ketamine. For those not familiar with ketamine, it is a sedative known on the street and party scene as “Special K”.
Ketamine is unique as a potential depression medication due to the speed at which it achieves effectiveness. Most antidepressants, including SSRIs, normally take a few weeks to months for the full effect to be reached. Ketamine, however, has been shown to relieve depression in a matter of minutes. While this sounds great, there are a number of drawbacks. The potential side effects of ketamine include:
- intracranial hypertension
- eye problems
- breathing problems
Despite these potential hurdles, the over 70% efficacy for depression alleviation in treatment-resistant sufferers is prompting pharmaceutical companies to come up with a ketamine formulation without the problematic side effects. At the moment, injections of ketamine would be required every week or two. Drug companies are trying to alter this model by producing different methods of delivery including nasal sprays and pills.
Aside from the speed with which it works, ketamine is also unique in the way it targets depression. SSRIs work by regulating serotonin levels, and new combination drugs also target norepinephrine levels. Ketamine works differently by blocking a brain receptor called N-methyl-D-aspartate, also known as NMDA.
NMDA is associated with a number of different brain mechanisms, including learning and memory, but has been recently pinpointed as a potential cause for depression. Ketamine is currently FDA-approved for anesthesia, but doctors who inject their patients with the drug as treatment for depression are doing it “off label”. Using a medication for off label treatment is somewhat controversial, so getting FDA approval for ketamine therapy for depression would be a big step. Drug trials for depression-targeting ketamine are in the late stages, but it could still be years before ketamine-based treatments appear in pharmacies.
Will ketamine prove to be as revolutionary to psychiatric treatment as Prozac? If the results from clinical research trials are any indication, it is likely to be a much more effective and powerful tool in treating even resistant depression than any drug in the SSRI family.