Depressed? Your doctor might soon prescribe ketamine
It may take some time to get the general public used to the idea of treating mental illness with drugs many associate with hard partying, but the medical community is jumping aboard the psychedelics train
New Jersey psychiatrist Steven Levine first thought of using ketamine in his practice when a patient came in whose depression could not be lifted by any commercially available antidepressants. After talking to Levine for a while, the patient confessed she felt better when she self medicated with cough syrup. When Levine looked up the active ingredient in the cough syrups the patient used, it was dextromethorphan, which, like ketamine, can induce a dissociative state or a detachment from reality.
You have to be looking in order to find something, says Levine, who is now one of a few practitioners who administer ketamine for depression, along with a few research centers. When he started out, dosing his first patient in 2011, he was as far as he knows the first to offer it outside a research setting. Levine was tired of the available drugs for depression, which have a high side effect profile and are ineffective for some patients.
Only around 45% of patients respond to traditional antidepressants, leaving a huge population that continues to suffer.
Levine was seeing patients who had failed on every class of antidepressants, who had submitted to dramatic last line treatments, like electroconvulsive therapy and transcranial stimulation, and were still depressed.
Unlike with traditional antidepressants, which can take weeks to show any impact, within a few hours, when Levine administered ketamine, it was obvious if it had worked or not. Patients “don’t wake up with a blue bird on their finger”, says Levine, but they do get better.
Since 2011, he has given ketamine to 600 patients. When he administered it only to patients for whom no other treatment had worked, Levine found that 70% got better using ketamine. For the past year he has also been treating patients who have not had any success on two types of antidepressants, and with the addition of that patient population, his success rate is now closer to 80-85%.
While ketamine is not indicated for depression, doctors can prescribe medications off-label at their discretion. Unlike other psychedelic drugs that have also been investigated for their ability to help treat mental illness, like MDMA, ketamine is a legal, widely available and easy to procure medication, says Levine.
Source: The Guardian