Could injectable drug unlock darkness of depression?
Infusions of ketamine being used off-label
HOUSTON – Treatment for depression can take several forms, including prescription medication, electroconvulsive therapy and for those who don't respond to traditional treatments, there's a promising, but controversial option.
Brian Ehlers and Nicole Winkler don't know each other, but they share a parallel experience: deep depression that started in childhood.
"It sucks all the good things away from you in your life it takes away," Ehlers said. "It takes away tomorrow and without tomorrow, life isn't really worth living, is it?"
"Depression, everything is dim," Winkler said. "Things that you love hold no value anymore and you physically manifest the stress you feel."
Ehlers and Winkler are among the 30 percent of Americans who don't respond to conventional treatment therapies for depression.
"I had a horrible experience," Winkler said.
"It gets to the point inside of you where you know there's just nowhere to go," Ehlers said.
Ehlers was on the verge of getting electroshock therapy when he learned about ketamine, what some know best as a psychedelic club drug called "Special K."
"Some drugs can be abused that are medically useful, and there's nothing we can do about that," Dr. Raul Cruz said.
"We're using extremely low doses, subanesthetic doses," Dr. Marc Ettensohn said.
Even so, some patients do experience a "ketamine high" from the treatment.
"But that passes after 30 to 40 minutes, and you feel completely normal," Ehlers said.
Toxicologist Alberto Augsten said in the wrong patient, ketamine could cause serious side effects.
"For instance, someone that's predisposed to psychosis or schizophrenia, ketamine will make them even more psychotic," Augsten said.
Ketamine is not approved for the treatment of depression, so patients have to pay out of pocket for a series of infusions that can cost several thousand dollars. That expense adds up because the treatment needs to be repeated.
"Some patients will come back as frequent as once every month. Others will come back less than once every year," Ettehsohn said.
"We don't want people to keep coming back forever, but if they need to come back for a year, that's totally fine," Cruz said.
While the long-term effects of the drug are unknown, Ehlers and Winkler credit ketamine injections with finally lifting them out of the darkness of depression.
"I felt it was worth the risk and I'm glad I did it because it changed everything from day one of the treatment," Winkler said.
"I was without any further recourse, wouldn't be here. I would have committed suicide," Ehlers said.
Two major pharmaceutical companies are now fast-tracking new medicines inspired by ketamine. A nasal-spray version of the drug could be on the market by this time next year.
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