• Eric Milbrandt, MD, MPH

Ketamine for Treatment-Resistant Depression: Top 10 Medical Innovations of 2017 (Cleveland Clinic)

A loss of hope is a classic symptom of depression. For many patients, hope has been restored with medical innovation. Drugs and therapies have been developed over the decades that help to balance or trigger serotonin, norepinephrine, and other neurotransmitters. But for one-third of depressed patients, the medications are not sufficiently effective, further diminishing any hope of returning to normal. Patients may receive electroconvulsive therapy or other intensive treatment options. Yet too often, the last resort is suicide.

In 2013, ketamine, a drug commonly used for anesthesia, was studied for its ability to target and inhibit the action of N-Methyl-D-aspartate (NMDA) receptors of nerve cells. The results were overwhelmingly favorable. Initial studies indicated that 70% of Treatment-Resistent Depression (TRD) patients saw an improvement in symptoms within 24 hours of being injected with a low dose of ketamine. These rapid timelines raised eyebrows in the industry, as typical treatments take nearly a month to evaluate the efficacy. For the first time, there was hope for the severely depressed patient that requires more rapid response or has failed medication options.

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