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Party drug ketamine closer to approval for depression

From CNN:

The Food and Drug Administration put the experimental drug esketamine (also known as ketamine) on the fast track to official approval for use in treating major depression, Janssen Pharmaceutical announced Tuesday. This designated "breakthrough therapy" would offer psychiatrists a new method for treating patients with suicidal tendencies and would qualify as the first new treatment for major depressive disorder in about half a century.

In some quarters, though, this potentially effective medicine can't escape its reputation as "Special K," a street drug known for producing a high similar to an out-of-body experience -- and sometimes used as a date rape drug.

Ketamine was first synthesized in 1962 by Calvin Stevens at Parke Davis Laboratories, according to Encyclopedia Britannica. It received FDA approval for use in humans in 1970, and shortly after, Army doctors used the drug on American soldiers fighting in Vietnam as an analgesic and sedative. Yet its minor hallucinogenic side effects soon warned doctors off treating people. Today, ketamine's most common use is as a veterinary anesthetic.

A concern with using ketamine to treat depression is that it can reverse tolerance to opioids, Coffman said. Essentially, patients will get a higher dose of pain medicines, she explained, so any psychiatric uses would require "close oversight" by a multidisciplinary team of doctors.
Iosifescu said the short-term effects are known, but the long-term effects remain mysterious.
 
Another concern is the similarity between prescription ketamine and the street drug, a substance of abuse.

These are all reasons why Janssen's formulation will be provided and administered in doctors' offices or clinics, not distributed by pharmacies.
Posted: 8/22/2016 10:21:00 AM

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Club drug ketamine cures depression instantly: How?

From CBS News:

What's the latest recreational drug to make its way to the medical field? Ketamine, also known as "Special K." The club drug, typically used by veterinarians as a cat tranquilizer, is said to provide patients an "instant" relief from depression, according to a new study.

Doctors at Ben Taub General Hospital in Houston are now experimentally using the drug to treat some patients who come to the emergency room with suicidal depression, NPR reported.

Dr. Anu Matorin, medical director of the Psychiatric Emergency Center at the hospital, told NPR that antidepressants may help suicidal patients eventually, but often take weeks or months to kick in. During the critical few days when very depressed patients have suicidal thoughts, they may be a threat to themselves or to others and are sometimes admitted to inpatient units.

That's why researchers at Ben Taub are among a growing number of scientists trying to transform psychiatric care - with the help of the club drug. Previous research suggests the anesthetic ketamine could help treat depression almost instantly.

Ketamine works differently than other antidepressants. While pills like Prozac boost the levels of the neurotransmitter serotonin to make people feel less depressed over a period of time, an injection of ketamine works on an entirely different neurotransmitter, glutamate. It blocks the receptors critical for receiving glutamate's signals which quickly improves the brain cell's electrical flow. That in turn reduces depression, according to the NIMH.

Dr. Asim Shah, who directs the mood disorder program at Ben Taub General Hospital, told ABC News the researchers hope the effect lasts.

"Will it cure depression for a year or longer? I don't think so," Shah said. "But we're hoping it will work for a few months"

But that doesn't mean people should self-medicate with the illegal drug. Ketamine is popular and "dance clubs and raves," and can be injected, consumed in drinks, or added to smokeable materials, according to the U.S. Drug Enforcement Administration. Some users fall into a dissociative "trip" on the drug, which is called a "K-hole."

Posted: 1/31/2012 3:12:00 PM

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