Could ketamine treat severe depression? | Smart News

At least 10% of the population of the United States will suffer from a major depressive disorder at some point in their lives – researchers estimate that it affects approximately 21 million American adults. But for those who don’t respond well to antidepressants, or about a third of clinically depressed patients, only limited treatment options remain. Currently, electroconvulsive therapy, or ECT, is the fastest and most effective route for these patients.

“ECT has been the gold standard for the treatment of severe depression for over 80 years”, Amit Anandpsychiatrist at Harvard Medical School and director of translational clinical trials in psychiatry at Mass General Brigham, says in a statement. “But it’s also a controversial treatment because it can lead to memory loss, requires anesthesia and is associated with social stigma.”

Now, a new study published in the New England Journal of Medicine suggests that the anesthetic ketamine might be at least as effective as ECT in treating severely depressed patients who do not suffer from psychosis. The study is the largest comparison of the two treatments ever and the only one to measure impacts on memory, the statement said.

The researchers conducted the trial between 2017 and 2022 with 365 patients. For three weeks, participants received either intravenous ketamine twice a week or ECT three times a week. Patients were followed for six months after treatment and completed a symptom questionnaire, which included memory tests and questions about quality of life.

About 55% of participants who received ketamine reported a 50% improvement in their symptoms and quality of life that lasted throughout the six months, compared to 41% of those who received ECT. While ECT was associated with memory loss and musculoskeletal adverse effects, the only side effect of ketamine was dissociation during treatment.

Roger S. McIntyrea University of Toronto psychiatrist and pharmacologist who was not involved in the research, says New York Times‘ Christina Caron the study is ‘groundbreaking’.

“It’s this kind of rigorous, randomized, realistic pragmatic data that is robust and very clinically meaningful,” he told the publication.

But some scientists are concerned about ketamine’s abuse potential, particularly because its long-term use has not been thoroughly examined. Researchers cite the opioid epidemic as a cautionary example.

“Why do we think ketamine will be different? If you ignore the risks and expand access as aggressively as possible, we will be in the same place in ten years,” Boris Heifetan anesthesiologist who studies ketamine at Stanford University and was not involved in the new research, says Olivia Goldhill of New statistics. “Ketamine is not oxycodone. But he has a responsibility for abuse. Even though it’s relatively modest, if you give it to enough people, the math is earth-shattering.

Although ketamine has been used in health care since the 1960s, research on its antidepressant effects has only increased in recent decades. In recent years, recreational use of ketamine has has gained popularity due to its hallucinogenic and dissociative effects.

Yet the abuse potential of ketamine must be considered alongside the link of ECT to long-lasting cognitive problems – some ECT patients have experienced permanent memory loss.

“It’s a question of assessing the risks for each patient,” says Heifets. New statistics. “None of these things are risk-free or transformative.”