Ketamine has served as a potent anesthetic for many years, but has gained popularity as a recreational narcotic in recent decades. However, recent breakthroughs have changed the role of ketamine. Ketamine has emerged as a powerful tool for treating severe treatment-resistant depression that has failed to address conventional pharmacotherapy.
A recent extensive study was published in a prestigious journal. New England Journal of Medicine Ketamine treatment was found to be equally effective in people suffering from unresponsive depression, comparable in effectiveness to electroconvulsive therapy, the currently available state-of-the-art treatment, and with fewer side effects. Ketamine and its derivatives are crucial in combating the epidemic that kills thousands of people each year in Israel and kills more than a million people worldwide.
This landmark study, the most comprehensive and significant to date, reveals that ketamine treatment is on par with the most powerful existing treatments for resistant depression. We are investigating the potential of this substance, originally an anesthetic, then an over-the-counter drug, and more recently re-evaluated as a treatment for non-responsive depression, for electroconvulsive therapy, the current mainstay of treatment for acute depression. Masu.
Studies have demonstrated that ketamine is consistent with the effectiveness of electric shocks. A closer look at the studies highlights that ketamine treatment is often superior to electroshock, especially with regard to side effects.
It is estimated that 15-30 percent of the world’s population will experience significant depression during their lifetime. In Israel alone, that number reaches two to three million. Various types of antidepressants developed since the 1950s can help many patients, but about 20% of patients do not respond to these conventional drugs or show only partial improvement. I have a problem. Certain patients who do not respond to drug-based therapy find relief in targeted psychotherapeutic approaches such as CBT and IPT, which are beneficial but have limitations. This means long periods of depression, immense suffering for patients and their families, and significant disruption to the daily lives of hundreds of thousands of Israelis. Moreover, depression is deadly, with approximately one million people committing suicide due to depression every year worldwide.
Currently, the most effective treatment for resistant depression involves electroconvulsive therapy given under general anesthesia. The psychiatrist appreciates the effectiveness of this approach, but he has three significant drawbacks:
- It carries a social stigma that deters many patients from pursuing it.
- Side effects, such as memory impairment, are usually temporary but cause problems.
- Given that resistant depression is a chronic disease, repeated electroconvulsive treatments are complex and inadequate to address a wide range of symptoms.
For decades after the advent of first- and second-generation antidepressants, psychiatry has struggled with treatment-resistant depression. The search for alternatives has driven the development of innovative techniques such as electromagnetic stimulation therapy (TMS). However, these methods tend to be costly and are unlikely to work as the high-volume solution you need. Therefore, intensified efforts to explore innovative drug treatments and overcome historical stigmas have led to a re-evaluation of familiar substances, including those once considered street drugs, and consequently their therapeutic potential. Sexual research has been neglected.
Over the past decade, the efficacy of ketamine in treating depression has attracted attention. The substance faced disqualification for its potential to induce psychotic and psychedelic experiences, similar to the “trips” and instant highs popularized as street drugs, but recent research results suggest that conventional treatments proved to be useful when Ketamine has been particularly recognized in the medical community as an anesthetic since the mid-20th century and continues to be used for short-term pediatric anesthesia and veterinary care. Despite initial skepticism due to the negative publicity of such drugs, accumulating evidence has highlighted the potential of ketamine to address treatment-resistant depression. Contrary to initial fears, the risk of addiction and psychosis does not seem too serious.
The use of ketamine has gained acceptance and has been incorporated into official psychiatric toolkits in many countries. To provide a comprehensive picture, a recent study enrolled about 400 patients with resistant depression at his five medical centers in the United States. This extensive study represents the most substantial clinical comparison ever made. The researchers deliberately targeted the most complicated cases, with 40% of the participants having previously considered other methods.
The research team divided the participants into two groups, one receiving electroshock therapy and the other receiving ketamine treatment. After 3 weeks of intervention, 55% of participants treated with ketamine reported a significant reduction in their symptoms of depression, outpacing the improvement of 41% of participants receiving electroconvulsive therapy. A follow-up evaluation performed 6 months later demonstrated that the quality of life measures in both groups were nearly identical.
One of the drawbacks of ketamine treatment is that it requires injections, which hinders its application and hampers its effectiveness for this widespread problem. Efforts are therefore underway to develop more user-friendly dosing methods while maintaining the efficacy of ketamine or its analogues. An effective approach involves distilling ketamine to produce esketamine, a molecule suitable for administration via nasal spray. This innovative technology eliminates the need for intravenous injections as it is absorbed through nasal capillaries. Esketamine’s efficacy against depression has been proven, and its easy-to-use dosing led to its approval by the US FDA in 2019, and was designated a “breakthrough drug” for the treatment of resistant depression. It has also received approval from the European Medicines Agency (EMA) and the Israeli Ministry of Health, and has joined the Israeli drug repertoire from 2020.
A further advantage of ketamine and esketamine treatment lies in the rapid response often experienced by people battling resistant depression. Currently, asketamine treatment is performed in specialized clinics, requiring patients to remain under observation for 2 hours after treatment. Although the process remains complex, the effort has proven worthwhile for individuals enduring long-term major depression, as evidenced by marked improvements under newer treatments. ing.
Sometimes these treatments work like a miracle. Substances such as ketamine and esketamine represent major advances in depression management. The For Life association, which focuses on suicide prevention, sees these drugs as promising tools to combat the ongoing deadly suicide epidemic. The author, Professor Haggai Harmesh, a respected psychiatrist and board member of the For Life Society, highlights the high potential of these drugs in combating this tragic scourge. .