July 12, 2019

ketamine for depression

Treatment resistant depression effects a third of those with major depressive disorder. With limited treatment options available for these people, there has understandably been lots of interest in research on ketamine as a new type of fast-acting antidepressant. In March this year the FDA licenced an esketamine nasal spray for treatment resistant depression in the US, which has only added to the excitement around this drug. However, with this excitement there have also been concerns around relatively sparse data on long term use, how and when exactly the drug should be given, and the potential for abuse.

Dr Carlos Zarate, from the National Institute of Mental Health (NIMH) in the US, has been a key figure in the discovery and evaluation of ketamine as an antidepressant.  He’ll be coming to the SMC ahead of the British Association for Psychopharmacology Annual Meeting – where he is the guest speaker- to describe his work. Joining him will be Prof Allan Young, the incoming president of the British Association for Psychopharmacology, and Dr Rupert McShane, who currently treats people in the UK with treatment resistant depression using off-label intravenous ketamine.

Together they discussed:

• Why do we need new types of antidepressants and how does ketamine work?
• Does the opioid system play a role and, if so, what does this mean for potential abuse of the drug? How can this be addressed?
• Do we have enough data on this drug to be sure of its efficacy and safety? What are the risks? Can this drug be used long term?
• Currently only licenced in the US, is it likely esketamine will soon be available in the UK? How does this nasal spray differ from the off-label use of ketamine?
• Will ketamine ever become a first line treatment for depression?

Speakers included:

Dr Carlos Zarate, Chief, Section on the Neurobiology and Treatment of Mood Disorders and Chief of Experimental Therapeutics and Pathophysiology Branch (ETPB) at the National Institute of Mental Health, and Clinical Professor of Psychiatry and Behavioral Sciences, at The George Washington University.

Dr Rupert McShane, Consultant Psychiatrist and Associate Professor, University of Oxford

Prof Allan Young, Professor of Mood Disorders, Institute of Psychiatry Psychology & Neuroscience, King’s College London (IoPPN)