Research Therapies — 12 April 2017

The horse tranquiliser, which is widely used as an illicit party substance, can be an ‘innovative’ option for tackling the mental illness.

Ketamine could treat depression: Report reveals party drug could be effective. Source: Getty

Ketamine could treat depression: Report reveals party drug could be effective. Source: Getty

However, experts warn more work is needed to find out exactly how much patients should be prescribed.

A report, co-written by Professor David Nutt, said the use of ketamine for medical purposes ‘does not violate ethical practices’ and could – in small doses – be used to treat people.

Their call was met with caution by other leading scientists, who suggested more research was required before it could be recommended for widespread use.

The paper based its recommendations on a study which gave more than 100 patients around 1,000 infusions of ketamine over the course of six years.

It found the drug could lead to rapid improvement in cases where all other avenues had been exhausted and had benefits lasting up to 14 days.

“I have seen ketamine work where nothing has helped before,” said Dr Rupert McShane, a consultant psychiatrist at Oxford Health NHS Foundation Trust.

“Ketamine is a drug not a miracle, and maintaining the benefit is a challenge. So far, the only way we have found to maintain the benefit is repeated dosing.

“We think that patients’ treatment should be in specialist centres and formally tracked in national or international registries.

“This will help us to pick up any safety or abuse problems with longer term use, and narrow down what dose, frequency, route and duration of treatment works best.”

Dr Paul Keedwell, Consultant Psychiatrist and Honorary Senior Research Fellow, Cardiff University said: “The effectiveness of low dose intravenous ketamine in the treatment of depression is one of the most exciting discoveries in psychiatry for years.

“Small doses have a dramatic and rapid effect on depression symptoms in many people who were previously resistant to treatment. The effect peaks at one day and can persist for a couple of weeks. Ketamine has also been shown to reduce acute suicide risk.”

The paper suggested guidance should be issued by professional bodies outlining the best means for using the drug as a treatment.

In 2014, ketamine was upgraded from Class C to B amid increasing concern over its physical and psychological effects.

There is evidence of users as young as 20 having their bladders removed due to heavy consumption of the drug.

Experts said further research can be carried out to reduce the risks presented by using ketamine to treat severe depression.

The paper concluded: “We hope that the recommendations proposed here go some way to enabling innovative use of ketamine for treatment-resistant depression to continue, with appropriate care, precaution, and foresight.”

However Professor Allan Young from the Royal College of Psychiatrists, said although the drug has showed ‘rapid improvements’ in mood, he warned there are still ‘significant gaps’ in knowledge about the dosage.

“Before ketamine can be recommended for use in clinical practice, extensive research is required to understand how to optimally use ketamine for treating depression,” he said.

“The Royal College of Psychiatrists has concerns for patient safety; and hence recommends mental health practitioners to proceed with caution when treating patients with ketamine.”

This piece was originally published on the ‘Express’ April 6, 2016.

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