Categories: Health

Ketamine tablets are effective for depression that does not respond to other medications.

Ketamine is a multifaceted and controversial substance: anesthetic, narcotic drug and antidepressant. When used under medical supervision, it demonstrates antidepressant potential with certain advantages over traditional drugs. Although this does not work for all patients, those who do experience results much more quickly.

From November 2022 The intranasal drug esketamine (a ketamine derivative) is available in Spain. for major depression, but only in certain cases; It is mainly intended for patients who have not responded to treatment with conventional antidepressants. The second phase of the clinical trial is currently underway, the results of which have been published in the journal. Natural medicine shows that long-acting ketamine tablets are also effective, safe, and well tolerated in patients with depression refractory to other treatments.

Compared to intranasal or intravenous ketamine, these oral tablets are easier to take and reduce the risk of abuse and cardiovascular side effects (hypertension and tachycardia). Besides, The intensity of dissociation or the feeling of being outside one’s body is less. associated with the use of this substance. However, these results need to be confirmed by additional studies including a larger number of patients.

Reduced symptoms of depression

A total of 231 patients who took 120 mg of the new dosage form in the first stage. drug for 5 days. Those whose symptoms improved went through a second phase, in which they were randomly divided into two groups: participants in the first continued to take the pills, and participants in the second received a placebo (an inactive substance).

Researchers from the University of Otago (New Zealand) found that 71% of patients in the placebo group experienced a relapse of depression after 13 weeks compared with the placebo group. 43% of those who received 180 mg ketamine orally twice a week.

In terms of side effects, people taking the drug experienced no changes in blood pressure, and the degree of sedation and dissociation was minimal.

Based on these results, the authors conclude that the use of a new form of ketamine may provide additional benefits compared to intranasal or intravenous administration because: In addition to reducing side effects, this makes administration more comfortable.without having to go to a medical center.

An effective drug, but not for all patients

Speaking to SMC UK, Paul Kidwell, a psychiatrist and member of the UK’s Royal College of Psychiatrists, said the new study “further highlights the impressive antidepressant effects of ketamine, but in a much more convenient and acceptable slow-dose form.” – release the tablet. The expert summarizes the most noteworthy findings: More than 70% of depressed patients who did not improve on an average of more than four different antidepressants responded to oral ketamine and more than 50% experienced complete remission of symptoms.

Moreover, “the researchers demonstrated an important advantage of oral ketamine: side effects were not significantly different from placebo,” the psychiatrist emphasizes. In other words, “the ketamine tablet, unlike the infusion, is well tolerated.”

According to the specialist, “the study raised the critical issue of maintaining improvement after the initial response.” In this sense, the results “suggest that many will continue to do well with long-term treatmentSo far, higher doses are being used, but more studies with larger numbers of patients are needed.”

Kidwell points out a potential downside to oral ketamine: “There is likely to be large interindividual variation in absorption and metabolism, so further research is needed to determine the ideal dosing regimen.”

Rupert McShane, consultant psychiatrist at Oxford Health NHS Trust and associate professor of psychiatry at the University of Oxford, UK, outlined the strengths and weaknesses of therapeutic ketamine to SMC: “The place of ketamine in the treatment of treatment-resistant depression is unclear.” This study confirms “that oral ketamine, like intravenous ketamine, is an antidepressant, but its effect is dose dependent.” In any case, he believes the results are “good enough to justify the larger phase 3 studies that would be needed to license the 180 mg twice-weekly dose.”