Three years after clinical trial, ketamine provides hope for severely depressed

Patients arriving at Dr. Philip O’Carroll’s Newport Beach office for their first ketamine treatment are in pain and often lost. They have visited other doctors, tried other solutions and are ready for what is considered a last resort.

They are led to a private room with a reclining lounge chair. Their blood pressure is checked, and they are handed a bottle of nasal spray. One whiff into each nostril, and they feel the edges of life suddenly soften. Tranquility overcomes them.

Some listen to music. Others watch television or sit quietly, perhaps even doze, and within two hours, their discomfort and brain fog have receded. The spiral of thoughts and feelings has slowed.

Since its approval by the Food and Drug Administration in 2019, ketamine or more specifically, its cousin — fast-acting, easily administered and insurance-billable — esketamine, has started to change the landscape of depression, especially where it borders on suicide.

O’Carroll is not a psychiatrist, but with 40 years of experience as a neurologist in private practice in Orange County, he has come to believe that there is little separating the mind and body. When one is sick, the other follows suit, and esketamine, he says, is a bridge between them, easing the distress that can be quite profound.

“It doesn’t work for everyone,” he said, “but when it does, it is truly astonishing.”

three years after clinical trial, ketamine provides hope for severely depressed

How To Save A Life

Pandemic stress, traumatic events and economic uncertainty have upended our world. This series aims to make the cascade of threats to your mental health a little easier to manage.

More Stories

Patients visit him complaining of headaches, fatigue and numbness, but he knows these symptoms can mask severe depression, which in the worst cases neither popular antidepressants nor psychotherapy can help.

Of the estimated 21 million Americans who have experienced a major depressive episode — for whom a wide range of effective treatments is available — close to 20% exhibit what is known as treatment-resistant depression, for which esketamine is offering hope.

“The allure of esketamine,” said O’Carroll, “is that it works quickly. Instead of four to six weeks as with other medications, it may take four to six hours, and in the case of suicidal ideation, it brings people back from the brink.”

For decades, pharmaceutical companies have tried to formulate a pill to cure depression. First there were tricyclic antidepressants, then there were SSRIs like Prozac and SNRIs like Cymbalta, drugs that target neurotransmitters such as serotonin and norepinephrine. But they take time to be effective and are often one step of many toward eventually treating this condition.

More specialized treatments — ECT, or electroconvulsive therapy, and transcranial magnetic and vagus nerve stimulation — are available but come with cumbersome mechanics, higher costs and side effects.

Ketamine, developed in 1962 and approved in 1970 by the FDA as an anesthetic, first gained notoriety as a recreational drug, but studies, conducted in 2000 and 2006, suggested its value for treating depression by targeting the neurotransmitter glutamate.

About 10 years ago, clinics popped up around the country, offering a generic, intravenous version, but without FDA authorization, insurance companies kept their distance and out-of-pocket costs could be $500 or more per treatment. Esketamine has changed that (most insured patients pay only a copay).

Dr. Paul Nestadt, a psychiatrist with Johns Hopkins University, helped run the clinical trial that in 2019 resulted in FDA approval. He had initially been skeptical about ketamine as viable treatment for depression, but the trials, which helped determine the best application of the drug, changed his mind.

Three years later, he has seen promising results from the use of esketamine. He also studies the role of impulsivity in suicide, so he knows the stakes are high. “It is good to have a treatment that acts fast,” he said.

Although the data of the most recent trial in his clinic have not been reviewed, he reports about three-quarters of “very treatment-resistant patients” show significant improvement in depressive symptoms.

“And the vast majority have tried some of our best treatment options, like ECT, without results as strong as they are getting with esketamine,” he said, noting that patients take the medication in conjunction with other antidepressants and psychotherapy.

As effective as esketamine is, Nestadt believes more research is needed. The medication is not as effective on anxiety, he said, and some patients find symptoms returning once treatments taper down from weekly to monthly.

A study published last month cited dizziness, nausea, sedation, vertigo and increased blood pressure after the first week of treatment, which is why O’Carroll, Nestadt and their staff monitor patients for the two-hour treatment. In addition, a few patients begin to feel an uncomfortable out-of-body sensation as the drug takes effect.

“That can be quite scary,” said O’Carroll, “so we treat it with Valium or Xanax.”

O’Carroll and Nestadt express a wariness toward the continued proliferation of unregulated spa-like clinics that prescribe a generic, non-FDA approved version of ketamine, either as an IV transfusion or a tablet, after an in-person or virtual consultation.

“They are dealing with a very vulnerable patient population who is desperate for anything new to try,” said Nestadt. “People are suffering, and we have treatments that work the majority of the time, but instead they are reeled in by some Silicon Valley-backed guru.”

O’Carroll is similarly conservative, arguing for careful oversight in the administration of ketamine and potentially other similar drugs.

One in a class of psychedelic-like medicines, ketamine joins LSD, ecstasy and psilocybin whose ability to create new connections in the brain — dendritic spines and axons — has provided researchers with a new understanding of the nature of depression and its cure.

News Related

OTHER NEWS

England predicted XI vs France: starting lineup and team formation for World Cup 2022 quarter final match

Gareth Southgate opted for just one change to the team that beat Wales in the final group game, with Bukayo Saka coming in for Marcus Rashford in attack. The 52-year-old ... Read more »

Prix du Cadran winner Princess Zoe could switch to hurdles

Group One-winning mare Princess Zoe might be tried over the jumps after failing to meet price expectations at Tattersalls last week. Read more »

Are Brazil worthy World Cup favourites at Qatar 2022?

Brazil are perennial World Cup favourites and now they have reached the quarter-finals at Qatar 2022, but can Tite's men justify favouritism and end 20 years of World Cup hurt? Read more »

Cesar Azpilicueta: Spain's new generation, like Gavi, is bursting with confidence

Spain defender Cesar Azpilicueta has been surprised by the confidence of Barcelona's Gavi as the teenager turns heads at the World Cup. Read more »

Bolster your home automation with this Amazon Echo Dot deal

Voice assistant technology has gone down some fascinating avenues, but controlling your home with your voice remains one of the core uses. This refurbished Amazon Echo Dot offers an easy ... Read more »

OpenAI's new ChatGPT bot: 10 dangerous things it's capable of

OpenAI’s newly unveiled ChatGPT bot is making waves when it comes to all the amazing things it can do—from writing music to coding to generating vulnerability exploits, and what not. ... Read more »

Former Florida GOP congressman arrested over ties to Venezuelan government

WASHINGTON —  A former Miami congressman who signed a $50-million consulting contract with Venezuela’s socialist government was arrested Monday on suspicion of money-laundering and representing a foreign government without registering. David ... Read more »

Girls’ basketball top 20: Sierra Canyon remains No. 1

Sierra Canyon and Etiwanda remain unbeaten and are Nos. 1 and 2 in this week’s top 20 high school girls’ basketball rankings compiled for The Los Angeles Times by CalHiSports.com ... Read more »

Traffic alert: Wreck has North Freeway northbound shut down at Airline

The wreck was reported a little before 6 a.m. Read more »

Ten ways to get help worth £100s paying energy bills as UK weather forecasts snow

HOUSEHOLDS are being warned to brace themselves for snow as a freezing storm causes temperatures across the UK to plummet. It comes at a time when millions of households are ... Read more »

India announces plans to end visa chaos for UK visitors

Bombay skyline in India – Getty After months of chaos and confusion, India has finally announced plans to restore e-visas for UK travellers. In a strange post-pandemic quirk, UK travellers ... Read more »

Daughter of ex-Thai PM Thaksin outlines opposition's vision

Daughter of ex-Thai PM Thaksin outlines opposition's vision The daughter of former Thai Prime Minister Thaksin Shinawatra is promising a new era of social equality, saying if her party is ... Read more »

3 railway workers killed, 4 wounded in Thai train bombing

3 railway workers killed, 4 wounded in Thai train bombing Three Thai railway workers have been killed and four others wounded when a bomb exploded as they were clearing the ... Read more »

Turkey again threatens Greece for arming Aegean islands

Turkey again threatens Greece for arming Aegean islands Turkey’s foreign minister has again threatened to “take action” against Greece if it continues to deploy weapons on its Aegean islands which ... Read more »

Mongolians protest alleged theft of coal sold to China

Mongolians protest alleged theft of coal sold to China Protesters have tried to force their way into Mongolia's State Palace, incensed by allegations of corruption linked to the coal trade ... Read more »

China blasts US report, reiterates 'no 1st use' nuke policy

China blasts US report, reiterates 'no 1st use' nuke policy China's Defense Ministry says the country strictly adheres to a policy of no first use of nuclear weapons “at any ... Read more »

Biden visiting Arizona as TSMC set to boost state's chip investment to $40B

The White House said TSMC's announcement furthers President Biden's economic agenda Read more »

US debt explosion funded by Americans, not foreign countries, posing risks to economic growth

US treasury holdings by China and Japan have been falling Read more »

Warnock Or Walker? Election Day Arrives for Georgia Runoff to Settle Last Senate Seat

The outcome will determine whether Democrats have an outright 51-49 Senate majority or control a 50-50 chamber based on Vice President Kamala Harris' tiebreaking vote Read more »

3-Alarm Residential Fire in Hyde Park Leaves 1 in Critical Condition

The Chicago Fire Department is responding and one person was critically injured after a residential building in the city’s Hyde Park neighborhood became engulfed in flames early Tuesday, authorities said. ... Read more »

Kim Kardashian gets restraining order against man claiming to speak with her telepathically

Kim Kardashian has been granted a restraining order against a man who has been trying to get in contact with her and claimed to speak with her telepathically, according to court ... Read more »

Thailand’s Prayut indicates 2023 election run for another term as PM

BANGKOK – Thailand’s Prime Minister Prayut Chan-o-cha said on Tuesday that he wants to rule until 2025, indicating for the first time that he plans to stand in Thailand’s upcoming ... Read more »

Underground restaurants, secret bars: Beijing residents dodge Covid-19 curbs

BEIJING – Dining in underground restaurants, drinking in secretive bars spread by word-of-mouth, and hiding their Covid-19 symptoms – some Beijing residents are defying strict curbs as the government tentatively ... Read more »

Bill making oath to King optional for Quebec legislators to be introduced Tuesday

Quebec’s governing Coalition Avenir Quebec is scheduled to introduce a bill Tuesday that would make swearing the oath to the monarch optional for members of the provincial legislature. Jean-Francois Roberge, ... Read more »

Georgia votes in U.S. Senate run-off between Warnock, Walker: Here’s what to know

Voters in Georgia head to the polls once again Tuesday to decide the final race of the U.S. midterm elections: a run-off for the state’s Senate seat that could have ... Read more »

Indonesia outlaws sex outside of marriage in revised penal code

Indonesia’s Parliament unanimously passed a long-awaited revision of the country’s penal code on Tuesday that criminalizes sex outside of marriage for citizens as well as foreigners, prohibits promotion of contraception ... Read more »

Baroness Michelle Mone: Tory peer to take ‘leave of absence’ from House of Lords amid PPE Medpro scandal

Tory peer Baroness Michelle Mone is taking a leave of absence from the House of Lords to “clear her name” over allegations over PPE contracts. According to documents obtained by ... Read more »

Waze starts to offer standalone built-in app for specific car models

Waze is getting a standalone app for some car models. Before this, if you wanted to use the app in the car, you would have to connect your smartphone to ... Read more »

Democrat Warnock hopes to boost party's U.S. Senate margin in Georgia runoff

Runoff U.S. Senate election in Atlanta By Nathan Layne ATLANTA (Reuters) – A Tuesday runoff election in Georgia between Democratic U.S. Senator Raphael Warnock and Republican former football star Herschel ... Read more »

Doehler Ventures invests in food-tech business Clean Food Group

Clean Food Group – a pioneering UK-based food-tech business that has developed a revolutionary and sustainable, bioequivalent alternative to palm oil has announced that it has received investment from Doehler Ventures, part of the Doehler Group, a global producer, marketer and provider of technology-driven natural ingredients, ingredient systems and integrated solutions for the global food, beverage and nutrition industry. Read more »

Supreme Court to Hear Arguments on Far-Reaching Elections Case

The Supreme Court will hear arguments on Wednesday about the independent state legislature theory, which contends that state judiciaries are powerless to modify or override decisions by state legislatures regarding ... Read more »

Kirsty MacColl death: how did Fairytale of New York singer die, how old was she - do The Pogues still perform?

British singer-songwriter Kirsty MacColl died, aged 41, 22 years ago this month. Despite not being an official member of Irish punk band The Pogues, it is through her collaboration with ... Read more »

DWP strikes: when staff are striking over Christmas in dispute over pay - will it affect benefits payments?

Staff working at the Department for Work and Pensions (DWP) are set to for two weeks . More than 200 members of the Public and Commercial Services (PCS) union are ... Read more »

Uber is offering NHS staff free rides and Uber Eats this Christmas - how to claim

Uber is offering NHS staff free rides and Uber Eats meals this Christmas as a gesture of thanks for their hard work. Eligible workers will have the option to claim ... Read more »

Latest Intel Arc beta driver boosts GPU performance in 13 games

Both old DX9 titles and newer DX11 and 12 games upgraded. Read more »

Deputies investigating deadly crash involving 18-wheeler in NW Harris County, sheriff says

Satsuma and the westbound lanes of Highway 529 are shut down as deputies investigate. Read more »

Colorado Springs Club Q shooting suspect to appear in court on Tuesday

Colorado Springs Club Q shooting suspect to appear in court on Tuesday The mass shooting at an LGBTQ club was being investigated as a hate crime. The suspect accused of ... Read more »

What to expect in Herschel Walker-Raphael Warnock Georgia Senate runoff

​The final​ Senate contest of the 2022 midterm elections will finally be decided in Georgia on Tuesday as voters choose between incumbent Sen. Raphael Warnock and Republican challenger Herschel Walker ... Read more »

Tom Brady makes record 44th fourth-quarter comeback as the Tampa Bay Buccaneers beat the New Orleans Saints

When his team trails in the fourth quarter, Tom Brady is almost inevitable. Down 13 points against the New Orleans Saints in the closing minutes, Brady steered the Tampa Bay ... Read more »

Fantasy football Week 14 waiver wire advice: Act quick after big injuries

Quick hitters and waiver wire advice for a handful of notable players after Week 13 of the fantasy football season: Hire learning Zonovan Knight RB, Jets A week late to ... Read more »
Breaking thailand news, thai news, thailand news Verified News Story Network