The scientists, from Oxford Health NHS, confirmed that some patients with severe depression who have not responded to other treatments, can be treated with ketamine which has a rapid antidepressant effect. Ketamine is a licensed medical drug and is very widely used as an anaesthetic and in pain relief. It is also used as a recreational drug or drug of abuse, and is to be reclassified as a Class B banned substance.
Generally electroconvulsive therapy (ECT) is considered in treatment-resistant depression. Although ECT is effective but there is risk of memory loss. There is a need for developing more treatment options. In the past few years, small randomised controlled trials have consistently shown that a single infusion of ketamine has a substantial and rapid antidepressant effect in some patients with treatment-resistant depression who have been taken off other antidepressants.
Principal investigator Dr Rupert McShane, a consultant psychiatrist at Oxford Health and a researcher in Oxford University’s Department of Psychiatry describes, ‘Ketamine is a promising new antidepressant which works in a different way to existing antidepressants. We wanted to see whether it would be safe if given repeatedly, and whether it would be practical in an NHS setting. We especially wanted to check that repeated infusions didn’t cause cognitive problems.
Ketamine did not cause cognitive or bladder side effects when given on up to 6 occasions, although some people did experience other side effects such as anxiety during the infusion or being sick. The team have now given over 400 infusions to 45 patients and are exploring ways to maintain the effect. They report their findings in the Journal of Psychopharmacology. The study was funded by National Institute for Health Research.
