A trial using oral ketamine and psychotherapy to treat treatment-resistant depression in Aotearoa is showing moods lift.
Treatment resistance, in which those affected do not respond well to at least two different antidepressants, is a problem for nearly one in three people diagnosed with depression globally.
Otago University scientists are theorising that ketamine can treat the disorder by helping the brain reset through “neurogenesis, the formation of new brain cells”, associate professor Dr Ben Beaglehole told 1News.
Participants are being given two doses a week of liquid ketamine mixed with orange juice.
“I was quite sceptical coming into the trial and doing these interviews, but people generally consistently describe a period of reprieve that they experience from their depressive symptoms,” senior lecturer Dr Jenni Manuel said.
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The Class C drug – used as a general anaesthetic – is traditionally administered by injection and it can be lethal, causing the death of actor Matthew Perry two years ago.
Beaglehole said while most previous studies have involved participants being injected with the drug, their trial is “trying to reduce the tripping experience”.
Their key method is having participants sip the drug mixture for 30 to 60 minutes.
“The dissociative effects are way more mild,” Manuel explained.
“So, they [patients] may have a little bit of disinhibition associated with it, and they talk about it being like having one or two beers.”
Half of the trial participants are also going to behavioural activation therapy – a form of psychotherapy – and researchers are hoping this will extend the improvement in mood, when the ketamine doses end after eight weeks.
Recreational use has been illegal in New Zealand since the 1980s. But in our hospitals, ketamine is widely used for sedation and pain relief.
A small number of private practitioners also prescribe it off-label for depression in oral doses.
But consultations cost hundreds, as do the bills for buying the drug monthly.
The researchers told the Royal Australian and New Zealand College of Psychiatrists’ conference in Dunedin last month they were also helping write guidelines for more psychiatrists to safely offer ketamine treatments.
“So, we think the current situation should change and that ketamine should become more available for psychiatrists and clinicians to prescribe in the public system,” Beaglehole said.
The researchers are still seeking people aged 18 to 65 in Christchurch and Dunedin with treatment-resistant depression to take part in the trial.
