The fast-acting drug offers a new way to treat depression and fathom its origins. Recent approval of a nasal spray promises to expand access, but much remains unknown about long-term use and the potential for abuse.
Jan Scerbo has suffered from depression her whole life. Last May, things got really bad. She was crying every day, and had trouble doing routine tasks such as showering. “It’s a really dark, deep tunnel,” she said. “It’s like you’re in this dark hole and you have to pull yourself out and you have to fight every day.”
A potentially life-saving treatment for depression recently got more convenient with the introduction of a new nasal spray called esketamine — a drug treatment that the Medical University of South Carolina helped research.
Janssen’s potential depression treatment made from esketamine – a version of the substance notoriously used illegally as a party drug – is to be reviewed by advisers to the FDA at a crunch meeting this week.
After her suicide attempt, Louise’s psychiatrist suggested she try ketamine. She agreed, and received an infusion intravenously. Within hours, her sense of well-being improved. The hospital discharged her. Back home, she discovered that going to the market was no longer a “herculean task.” Getting her car washed wasn’t an insurmountable chore. “Life was better,” she said. “Life was doable.”
As a journalist who covers health and medicine, I had read about the success of experimental trials that used ketamine to treat depression. My therapists had recommended extreme treatments like electroshock therapy, a procedure that frightened me due to reports of memory loss from those who had undergone it, but had never mentioned this. But I was getting desperate for a serious intervention.
Increased dissociative symptoms associated with ketamine infusion treatment can predict a greater antidepressant effect in individuals with major depressive disorder or bipolar disorder. In fact, specific properties of ketamine-induced dissociation (such as depersonalization and derealization) can uniquely predict the antidepressant response, according to a study published in the Journal of Affective Disorders.
Like a May shower, the studies on psychedelic drugs' potential therapeutic benefits came — first as a sprinkle, then a steady downpour. Between 2012 and 2017, the papers abounded. One, published in 2016, suggested that magic mushrooms might alleviate anxiety in cancer patients; another in 2017 indicated that ecstasy could help veterans cope with PTSD symptoms; and one in 2012 hinted that ketamine might curb major depression.