The U.S. Food and Drug Administration recently issued new guidelines for using ketamine and several drugs to treat PTSD, depression and other mental health issues.
“Inside the Issues” host Alex Cohen sat down with Dr. Andrew Leuchter, director of TMS Clinical and Research Service at UCLA, to discuss why some people are turning to ketamine to treat depression.
While typically known as a street drug, the substance is now being used to treat the most severe cases of depression. In instances where patients are not responding to first-line treatments, ketamine can provide relief, Leuchter said.
“The usual antidepressant medications like Prozac, Zoloft and other medications only work about half the time. When those medications fail, that’s when people want to be looking at things like ketamine or other treatments for what we call treatment resistant depression,” he added.
The UCLA doctor noted that ketamine should only be used in severe scenarios. The drug can be given either intravenously, through a nasal spray or in lozenge form. However, Leuchter recommended that taking it through the nose or mouth reduces costs and has less side effects.
He stressed the importance of patients understand the gravity of the drug.
“It did start as an anesthetic agent, so it is a serious medication,” he said. “It also has gotten some use as a drug of abuse. It can be used as a street drug. So there is some addiction or abuse potential there. So one does have to be careful that it’s regulated.”
The doctor noted that common side effects include feelings of disassociation, some psychosis and the possibility of growing dependent on it.
Most patients who turn to ketamine take it under the supervision of a doctor, but some physicians are prescribing it for people to take home and use. Leuchter added that close monitoring is still vital in these situations.
“What I encourage patients to do is talk with their psychiatrists and get consultations from experts in the field who can say, ‘OK, here are your options beyond the first-line treatments and help figure out what’s right for you,’” he said.
The doctor noted one of the most challenging aspects of treating depression is that little is known about the root cause of the mental health disorder.
While genetics can make some people more predisposed to depression, scientists are still struggling to make sense of why certain medications are more successful than others.
Leuchter is focused on studying the brain while patients undergo treatment.
“We record brain waves during treatment and look for exactly how the treatment interacts with the brain, looking for that signal that’s going to tell us this drug has sort of fit into a receptor,” he said. “It’s like a key into a lock. And if we turn that, then it’ll unlock the key to that patient getting well.”
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