A new world-first Kiwi study is exploring ketamine as a quick-acting anti-depressant, with billionaire Elon Musk among those touting its therapeutic benefits. Photo / Getty Images
A new world-first Kiwi study is exploring ketamine as a quick-acting anti-depressant, with billionaire Elon Musk among those touting its therapeutic benefits. Photo / Getty Images
A new world-first Kiwi study is exploring ketamine as a quick-acting anti-depressant, with billionaire Elon Musk among those touting its therapeutic benefits.
Long used in emergency departments and vet clinics, the dissociative anaesthetic is perhaps better known as the synthetic party drug ‘Special K’ – and remains a Class Ccontrolled substance in New Zealand.
Over the past 20 years, however, successive studies have shown its potential as an effective short-term treatment for major depression disorder (MDD).
It’s been approved as an intravenous treatment for depression in the UK and, in nasal spray form, in the US.
After theWall Street Journal last week reported Musk as being a microdoser of the drug, the world’s richest person claimed to his Twitter followers that ketamine “taken occasionally is a better option” than traditional medication for depression, citing the experience of “friends”.
Targeting a key chemical in the brain called glutamate, which affects memory and learning, the drug has been found to reduce depression symptoms much faster than other treatments, relieving feelings of sadness, helplessness and thoughts of suicide.
But in some places, including New Zealand, it remains controversial due to its hallucinogenic properties and the risk of abuse.
As a treatment, there also plenty of limitations and drawbacks that researchers were trying to understand, said psychiatrist Dr Ben Beaglehole, of Otago University’s Department of Psychological Medicine.
Its effects wore off over a few days, while its responses – and side effects – could vary from person to person.
“Most of the studies have been ketamine injections, which cause a significant dissociative reaction or trip and make it hard to translate the evidence into routine care by clinicians,” Beaglehole said.
While ketamine was known to block the glutamate receptor NMDA, Beaglehole said its actual therapeutic effects were likely to be more complicated and “downstream” from this mechanism, given benefits tended to work after its acute effects had worn off.
In a major new study, just awarded a $1.2 million grant from the Health Research Council, he and colleagues aim to answer some of the biggest questions surrounding the drug as a treatment.
One was whether giving it in liquid form - diluted with orange juice and sipped over 30 to 60 minutes – could make for easier administration and prevent users from having major trips.
Another was whether its short-term benefits could be extended by combining it with behavioural activation therapy, or BAT: an evidence-based approach where people are encouraged to do rewarding things, such as exercise or socialising, to help improve mood.
Half of the 60 participants in the study would receive the ketamine-based therapy alone, while the others would also undertake BAT.
“If BAT delays relapse or improves the response to ketamine, it will help improve ketamine treatment for MDD,” he said.
“We are looking to try to bridge the gap between something that works in research settings to something that has real benefits for people.”
The programme wasn’t the first in New Zealand to explore ketamine’s antidepressant actions – one 2019 University of Auckland study provided major insights into how it boosted the brain’s ability to form new connections.
New Zealand company Douglas Pharmaceuticals has been running clinical trials of slow-release ketamine tablets in Tauranga and Rotorua.
More recently, New Zealand company Douglas Pharmaceuticals has been running clinical trials of slow-release ketamine tablets in Tauranga and Rotorua, with the majority of patients in the second phase of the study reporting rapid relief for their treatment-resistant depression.
But Beaglehole said few studies had combined therapy and ketamine treatment of depression – and none yet had investigated using BAT and oral administration.
“We also want to explore other aspects of depression and its treatment by measuring cognition and activity.”
Psychedelics and depression
Australia has become the first country to classify psychedelics as medicines at a national level in an attempt to address mental health illnesses, and one prominent New Zealand ED doctor says they could potentially be used here.
Otago University researchers have been exploring whether magic mushrooms could also provide effective treatment for those with severe depression. Recent MRI-based studies of psilocybin, found within the mushrooms, found the substance created greater connections between different regions of the brain.
At the University of Auckland, Associate Professor Dr Suresh Muthukumaraswamy and his team have been investigating whether weeks of LSD microdosing could bring a big reduction in symptoms in patients with major depressive disorder.
In another Kiwi study, researchers are exploring if ecstasy or MDMA, combined with therapy, can help treat depression and anxiety in people with terminal cancer.
Jamie Morton, a specialist in science and environmental reporting for the New Zealand Herald, has spent the last decade writing about everything from conservation and cosmology to climate change and Covid-19.
