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A remarkable drug for severe depressions!! Used since long in the tropics

 

Going back some 39 years to my old file....long before our computer age:

Article about Ketalar in the journal: Tropical Doctor January 1974 [ was then working in Suriname ]

Remember using this drug for short anesthesia, lasting some 10- 15 minutes.

The article below is about this drug under the name of Ketamine, but now used for depressions.


Q. I received a ketamine infusion several months ago and it literally saved my life. My 30+ year depression was severe (unable to feel, no relationships, unable to work, extreme anxiety and fatigue, etc). I volunteered for a study at the National Institutes of Health for patients with extreme, treatment-resistant depression, where I was given ketamine.

The effect was instantaneous and miraculous. All symptoms were completely relieved within two hours. The relief lasted about two weeks. Most of my fellow patients at NIH experienced the same. There are many doctors now using ketamine in clinical practice for severe depression. I had no trouble finding one and have since been treated with ketamine for several months.

You cannot imagine the sensation of decades of suffering draining away rapidly. For the first time in my life (age 50) I am finally able to get out of bed in the morning, experience joy, socialize, work, date, etc. Ketamine doesn't work for every patient, but the response rate is astonishingly high (65-80%). If you are reading this post while suffering long-term, extreme depression: please consider volunteering for a ketamine study or find yourself a doctor who employs it in their practice.

A. Your experience has just been confirmed by new research published in the Journal of Psychopharmacology (online, April 3, 2014). A small study from the UK demonstrated that infusions of ketamine produced dramatic responses in severely depressed patients. Like you, some of these individuals had been suffering for decades.

Unlilke traditional antidepressants, which can take weeks to kick in, ketamine sometimes produces noticeable results within a few hours. The lead investigator, Dr. Rupert McShane, reported to the BBC that "It really is dramatic for some people; it's the sort of thing really that makes it worth doing psychiatry; it's a really wonderful thing to
see."

Although some of the patients had long-lasting benefit, others relapsed. But keep in mind that ketamine is not given daily like typical antidpressants. This study involved three to six infusions over a period of three weeks. One wonders what would happen if the drug were administered orally on a regular basis or over a longer period of time.

Ketamine was originally approved for human use as an injectable general anesthetic in 1970. It is especially helpful when severe pain is involved, such as in burn patients or during emergency surgery. That's because it is both an anesthetic and an analgesic, meaning that it provides significant pain relief while helping the patient remain unconscious. Because it opens airways, it is especially helpful for asthmatics or patients with COPD (chronic obstructive airway disease). Ketamine is also used by verterinarians for a wide variety of animal surgeries.

Caution about ketamine results in part because of its negative reputation as a club drug. The street name for ketamine is Special K. When taken orally, the drug produces a "dissociative" effect that some describe as detached or distorted. It is a shame that ketamine has been abused, since its antidepressant potential is so exciting. This may have delayed research into this promising treatment.

To learn more about ketamine in the treatment of severe depression, here is a link to an earlier post, "Old Drug Has New Tricks Against Depression."

Let us know your experience with depression. If you have participated in a ketamine trial, we would love to hear your story. You may also find our Guide to Dealing with  of value.

 

 



When someone is severely depressed, immediate action is essential. That's because without help or hope, a suicidal person may do himself irreversible harm.
The trouble is that most antidepressant treatments do not act quickly. It can take up to six weeks for medication to kick in. That may not be soon enough for someone with overwhelming depression.
In such situations, patients may be admitted to a psychiatric ward (voluntarily or involuntarily) where they can be observed and protected. Many such facilities are overwhelmed, however, and may not offer a healing environment.
An old medicine in new form may offer unexpected hope for such patients. Ketamine has been used as an anesthetic during surgery since the early 1970s. During the Vietnam War it was called the "buddy drug" since it could be administered on the battlefront by another soldier.
Ketamine continues to be prescribed for surgery on children and in veterinary medicine. The problem keeping it from being used more widely as a surgical anesthetic is that ketamine creates "dissociation." Users may feel disconnected from their environment and may experience distorted perceptions or even hallucinations.
While the dissociative experience posed problems in surgical recovery rooms, it made ketamine appealing as a club drug. Known as "Special K," ketamine is used around the world during raves or dance parties.
Researchers are rediscovering the fascinating pharmacology of this medication. Unlike conventional antidepressants such as fluoxetine (Prozac) or venlafaxine (Effexor), ketamine impacts the brain in a completely different way. Some small studies have uncovered remarkable effects against hard-to-treat depression.
Instead of taking weeks to change brain chemistry and relieve suicidal thoughts, ketamine goes to work rapidly. One pilot study compared a ketamine injection to placebo. The active drug produced a "robust and rapid antidepressant effect" within two hours that lasted nearly a week (Archives of General Psychiatry, Aug. 2006).
A disadvantage of such therapy, however, is the intravenous administration. It is inconvenient for many depressed patients to return to the doctor frequently for injections.
That is why there is such interest in a new formulation called esketamine, developed by the Johnson & Johnson pharmaceutical company. This medication can be used as a nose spray. Preliminary results are promising.
Other companies are also pursuing compounds that work on the same brain chemicals. GLYX-13 is being developed by Naurex. A study published in the journal Neuropsychopharmacology (April, 2013) found antidepressant activity without ketamine's dissociative side effects. The company is working on an oral version that could be used for treatment-resistant depression. These new drugs are likely to be submitted for FDA approval within the next several years.
In the meantime, however, some psychiatrists are already using ketamine injections for selected patients. Doctors can do this legally because ketamine is an FDA approved anesthetic drug
Such off-label prescribing has unknown drawbacks. We don't know how long-term use will affect brain function, but in a suicidal emergency the short-term benefit might outweigh the risks..