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‘Party drug ketamine fights worst depression’

October 7, 2012

This is no hallucination: ketamine, the party drug, is being considered the best bet against worst cases of depression.
After a decade of scientific work, Yale University researchers published in the Science journal that small amounts of ketamine could provide immediate relief to chronically-depressed and treatment-resistant patients. Co-author Ronald Duman has been quoted as saying this discovery could the “biggest breakthrough in depression research in a half century”.
Considered the commonest mental disorder, depression affects one in 5 women and one in 10 men. Depression, the theme of this year’s World Mental Health Week beginning on Monday, can range from minor mood disorder to debilitating depression. Antidepressants are helpful for most but some may be resistant to all known medications.
Ketamine helps regenerate synaptic connections between brain cells damaged by stress and depression, say Yale scientists Ronald Duman and George Aghajanian . It works on a different kind of neuro-transmitter system than available antidepressants. Discovery could lead to new class of drugs. In large doses, ketamine is abused as party drug ‘Special K’ .

Doctors sound caution on ketamine use 
Not all doctors are euphoric about the use of ketamine, better known as party drug Special K, for depression. Dr Sanjay Kumawat, who was formerly the medical superintendent of Thane Mental Hospital, said there is no knowing when the use of such stimulants could turn into addiction. “Depression also has a social or familial aspect that cannot be helped by ketamine,” he added.
Psychiatrist Dr Harish Shetty said the idea of treating depressed patients was to get them into euthymia or good mood. “The aim isn’t to put them on hypomania status (a level just below mania). Ketamine or any stimulant would change one’s mood much beyond normal,” he added.
But some doctors point out that stimulants have long been used to treat depression. “Ketamine is a wellknown temporary anti-depressant for people who don’t respond to other medicines,” said Delhi-based psychiatrist Sunil Mittal, adding that it’s a tradeoff between severe disabling depression and the side-effects of stimulants that include hallucination and memory loss.
Jaslok Hospital’s Dr Shamsah Sonawalla said: “As it is a stimulant, ketamine’s dramatic effect on depressed patients is not surprising. It can hold a ray of hope for treatment of depression only when its safety issues are ironed out.’’
Among other stimulants, amphetamine and methylphenidate (which is used to treat attention-deficit hyperactive disorder), too, have been used off-label for severely depressed patients. Dr Shetty, in fact, pointed to an opposite trend.
The Yale researchers showed that stress and depression lead to loss of neurons, while the use of ketamine showed the development of new synapses or nerve connections. “Understanding how ketamine works in the brain could lead to the development of an entirely new class of anti-depressants, offering relief for tens of millions of people suffering from chronic depression,” they said.
As Dr Mittal put it: “We must remember that ketamine began as an anaesthesia medicine. Like many other psycho-active medicines, it was abused and gained a reputation of being a party drug.” Possession of ketamine is banned in India under the NDPS Act since this February. Safety concerns abound about its use. Hallucinations, psychosis and memory loss may not be the price all want to pay.

Categories: Public Health
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