The notion of using ketamine as an anti-depressant is gathering steam on the back of enlightening research that has shown us how it can suppress the brain’s “anti-reward” center, mend broken neural circuits and interact with serotonin receptors to boost the release of dopamine. A new study has shown how this might work in practice, with chronic suicidality sufferers offered rapid relief through regular oral administration of the drug in clinical settings.
Among the many studies to probe the anti-depressant effects of ketamine was one published in 2017 which focused specifically on suicidal patients, the first to do so. The authors found that low-dose infusions of ketamine caused a major reduction in suicidal thoughts just 24 hours later, and had positive effects on mood, depression and fatigue that lasted for at least six weeks.
This new study, carried out at the University of the Sunshine Coast in Australia, again focuses on sufferers of acute suicidality, with the team hoping to build on earlier research, which has demonstrated ketamine’s anti-depressant potential when delivered via injection.
“Intravenous administration, however, is invasive, expensive and carries a higher chance of adverse reactions due to its injection straight into the blood stream,” says principal investigator Dr Adem Can. “So logistically it is a lot easier and faster to clinically administer an oral dose.”
The study involved 32 adults suffering from chronic suicidal thoughts, who were administered ketamine orally over a six-week period, The subjects were assessed using standard scales for suicidal thoughts and depressive symptoms, with 69 percent of them showing clinical improvement at the six-week point. Half of them, meanwhile, still reported significant improvements four weeks after the final dose.
“On average, patients experienced a significant reduction in suicide ideation, from a high level before the trial to below the clinical threshold by week six of the trial,” Dr Can says. “In medicine, this response rate is significant, particularly given it was experienced by patients with chronic suicidality, which can be difficult to treat.”
The study size is small but the team is enthused with the results, particularly because of the range of afflictions suffered by the subjects that led to their suicidal thoughts, including depression, anxiety and borderline personality disorder.
“Yet the treatment still worked across the group,” says study supervisor Professor Jim Lagopoulos. “This means the trial group was representative of the community we are serving, where suicidality is often accompanied by one or more other conditions. So results like these across the spectrum are very encouraging.”
The team does note, however, that more research is needed to further explore the efficacy of oral ketamine doses across randomized control groups.
The research was published in the journal Translational Psychiatry.
Source: University of the Sunshine Coast
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