‘Special K’ for depression?
FDA considers party drug for treatment
If you suffer from major depression, it’s possible your doctor might prescribe the party drug known as “Special K,” or ketamine, to help you.
In August, the U.S. Food and Drug Administration (FDA) classified ketamine as a drug that could help improve symptoms for people with serious depression with constant suicidal thoughts, according to pharmaceutical company Janssen Research & Development LLC.
The FDA awarded the drug a “breakthrough” designation. This label means that the drug treats a serious condition and initial research suggests it may do much better than existing treatments in some way. Breakthrough designation helps speed up the process for getting a drug approved and available on the market.
About 15 million people in the U.S. have major depression, according to the National Institute of Mental Health. Depression puts you at higher risks of dying from suicide as well as other causes, such as heart disease, according to the CDC.
What is ketamine?
Kimberly Kjome, MD, a psychiatrist at Ascension Seton Shoal Creek Hospital, part of Ascension, said ketamine is used as a surgical anesthetic for people and animals. It can come in liquid or powder form. The drug makes users feel less worried and more disengaged from the situation.
“People misuse ketamine because of the dissociated high it creates,” Kjome said. “They like the feeling of being outside of their body and outside of place and time.”
Ketamine has been around since the 1960s and began to be abused as a party drug in the 1980s, she said. The drug is similar to PCP, or phencyclidine, which has also been used as a party drug, she said.
If the FDA approves the drug to treat depression, ketamine would be one of the first new approaches to treat major depression for patients in the last 50 years, according to Janssen.
Research about ketamine is still ongoing. It’s not yet clear how often a person needs to receive infusions and also how the drug could treat depression for a longer period of time. Studies are also being done on medicines that are similar to ketamine but with less risk of abuse.
“Most of the FDA studies look at the short-term effects of ketamine. There have been very few that have looked at the long-term treatment of people with ketamine and also the effects of using it for a long time,” she said. “This is spurring a lot of research because the Drug Enforcement Administration has classified ketamine as a drug that is useful but there is also a lot of abuse potential as well. It recognizes that in the hands of the wrong person, it could lead to some abuse or misuse potential.”
How can ketamine be used to treat your depression?
If you were prescribed ketamine to treat depression, you would receive infusion treatments through IV injection in a doctor’s office. Although the infusions would not cure depression, they may help relieve symptoms for a short period of time. Some studies show that people begin to feel better very quickly after an infusion treatment, Kjome said.
You would only be considered for ketamine infusions if other antidepressant drugs and therapies have not worked for you in the past, she said.
Some of the concerns about using ketamine are the side effects it can have, such as psychosis, violence and agitation, Kjome said.
It’s important to know who would not be a good candidate for ketamine infusions, including those who are addicted to pain medications.
“There would be a lot of responsibility on the doctor to make sure their patient meets the criteria for treatment. Otherwise there will be legal problems to giving someone ketamine if they didn’t need it,” she said.