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The increasing use of ketamine to treat depression comes as research shows that administering the drug in sustained-release tablet form reduces side effects when taken through the nose or bloodstream.
An international group of scientists concluded that patients who received the orally administered drug largely avoided problems such as sedation, elevated blood pressure and dissociation.
Ketamine has long been used medically as an anaesthetic and recreationally by club goers, but mental health experts and employer As a treatment for depression that is difficult to alleviate by other means.
The new research suggests that the pill could be a much easier way for patients to take the drug, said Professor Paul Grew, co-author of the 2011 paper. Nature Medicine on monday.
“Injected or intranasal ketamine needs to be administered in a clinic, and patients need to remain there for a couple of hours to recover from side effects and be monitored for safety,” said Grew, an expert in psychological medicine at the University of Otago in New Zealand. “Potentially, sustained-release ketamine tablets could be administered by patients themselves at home, shortening the time spent in the clinic and potentially causing little to no side effects.”
The scientists analyzed a new ketamine tablet called R-107, developed by New Zealand's Douglas Pharmaceuticals, which has a slower acting drug action, meaning most of the ketamine is broken down in the liver and less of it enters the bloodstream, but the breakdown products still have antidepressant effects, so the treatment is still effective.
The scientists found that of 168 depressed patients who received R-107 twice weekly, 43 percent relapsed after 13 weeks, compared with 71 percent of those who received a placebo. Glu and his colleagues from Australia, New Zealand, Singapore, Taiwan, and the UK said they saw no changes in blood pressure in the ketamine pill group, and reports of sedation and dissociation were minimal.
The findings are the latest contribution to a growing body of research on the efficacy of oral ketamine treatment.
The study could help overcome financial barriers to using ketamine as an alternative to drug-resistant depression treatments, such as electroconvulsive therapy: both the intranasal treatment and the clinical equipment needed for intravenous administration are expensive.
The study highlights the “remarkable antidepressant effects of ketamine” and suggests it could be administered in a “much more convenient and acceptable form”, said Dr Paul Keedwell, consultant member of the Royal College of Psychiatrists.
Because how ketamine is absorbed and broken down likely varies widely from person to person, more research will be needed to pinpoint the ideal dosage, said Keedwell, who was not involved in the study.
“Their results suggest that many people can do well with long-term treatment, provided they take high doses, but further studies with larger numbers of patients are needed,” he said.
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