Individuals suffering from depression may be able to find new hope in the form of an old drug known as ketamine through a private clinic called KetaMind which offers ketamine as a treatment for depression.
KetaMind was recently opened in Israel and founded by psychiatrist Dr. Stuart Seidman and emergency medicine specialist Prof. Michael Drescher.
Researchers in recent years have begun experimenting with ketamine as a possible treatment for depression after those diagnosed and given ketamine to treat unrelated conditions reported significant improvement in their mood and overall mental health. Studies conducted in the United States show that a series of ketamine treatments can reduce symptoms of depressive disorder in 70% of patients and that symptoms can almost completely disappear in about 50% of patients.
Such high success rates are rare in mental health care, so researchers have also begun experimenting with the drug as a possible remedy for other conditions such as anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and chronic pain disorder. Studies have shown high success rates in these cases as well.
Ketamine is most commonly used as a dissociative anesthetic, however it has also been used in place of morphine to treat acute pain and is a popular recreational drug. First formulated in the 1960s, ketamine is defined by the World Health Organization (WHO) as an essential drug for healthcare worldwide.
Esketamine is an imperfect substitute for ketamine
Because ketamine is an older drug and its patent period has expired, it could not be submitted to the FDA for approval for its use as a treatment for mental health conditions. Despite this, there are currently over 1000 clinics in the United States offering ketamine to those suffering from depression and other mental health issues. This is done through the “off-label” method, where doctors use a drug intended for one specific use to treat an entirely different health issue.
To make ketamine treatment more accessible to people with depression, the American pharmaceutical company Janssen has developed a subtype of the drug called esketamine. It has been patented and approved for use as a mental health treatment in both the United States and Israel. Esketamine is included in the Ministry of Health service baskets and can be obtained at psychiatric hospitals and clinics. Eskematine is administered via a nasal spray, as opposed to ketamine which is administered via intravenous infusion.
Despite its greater accessibility, there are some issues with using esketamine as a substitute for ketamine. The waiting list to receive the drug can take several months, some patients prefer not to be treated in a hospital setting, and the nasal spray is less effective than the injection. The KetaMind clinic, which has already started treating patients, is perhaps a good alternative.
“The process is a bit complex,” explains Prof. Drescher, “in the USA, any doctor can use an FDA-approved drug [American Food and Drug Administration] for any treatment, even for the treatment of conditions other than the original use for which the drug was approved, without further regulatory process. In Israel, it is necessary to obtain individual approval from the Ministry of Health for each of our patients suffering from depression, in order to help them with ketamine. Fortunately, Ministry of Health pharmacists are well aware of the suffering of patients and even the risk of suicide for some of them, and they work with us to ensure we get approval for the use of ketamine for patients who need it.” .
Ketamine can save lives by reducing suicidal thoughts
Major depressive disorder is a severe mood disorder that causes feelings of hopelessness and despondency. Other symptoms include insomnia, disordered eating, loss of motivation, anxiety and irritability. Depression can be fatal as many people with the disorder experience suicidal ideation. According to the WHO, more than 700,000 people die by suicide every year worldwide and according to the Ministry of Health, in 2019 there were 6,859 suicide attempts and 428 suicides in Israel.
One of the most significant benefits of using ketamine as a treatment for depression is that it reduces suicidal thoughts in patients, sometimes even soon after administration of the drug. Suicidal thoughts and subsequent suicide attempts are often caused by a momentary crisis and therefore if an individual experiencing suicidal ideation can overcome the dangerous moment, the thoughts may pass. Even if the thoughts only pass temporarily and then return, a common pattern in cases of depression, it gives the person the opportunity to seek help and receive the necessary treatment. Ketamine could be a life-saving treatment.
While ketamine has the potential to be a game-changing drug in the mental health world, it’s still important to note that it’s not a magical cure. There are some who do not respond to treatment, those who do respond may find that the benefits have weakened after a period of time and repeated use may be required to be effective. The good news is that ketamine is considered safe when used correctly and there are very few side effects.
The only notable side effect is the anxiety and emotional distress caused by the experience of the treatment itself. Since ketamine is an anesthetic, patients enter a dream state of consciousness soon after administration of the drug. While some people find this mood pleasant or even euphoric, others may find it disturbing.
Doctors speculate that the positive ketamine results are not caused by the patient’s experience during the treatment itself, but instead are due to changes occurring in the brain cells themselves. One theory is that it actually rewires the brain by stimulating synapse regrowth.
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