Last month, the FDA approved a ketamine-based depression treatment for certain patients.
The drug, esketamine, is said to relieve depression symptoms “in hours instead of weeks,” marketed for people who haven’t found success in other antidepressants.
While it is yet unknown how exactly ketamine helps lift depression symptoms, a new study gives us a better understanding of how it works.
The research confirms that ketamine triggers synapse growth, effectively rewiring the brain, Scientific American reports. They were able to “visualize and manipulate” the brains of stressed mice—demonstrating how ketamine first changes brain circuit function that improved behavior in “depressed mice” in up to 3 hours. Later, the drug stimulated regrowth of synapses in the brain.
“It’s a remarkable engineering feat, where they were able to visualize changes in neural circuits over time, corresponding with behavioral effects of ketamine,” said Carlos Zarate of the National Institute of Mental Health, who was not involved in the study. “This work will likely set a path for what treatments should be doing before we move them into the clinic.”
“Our findings open up new avenues for research, suggesting that interventions aimed at enhancing the survival of these new synapses might be useful for extending ketamine’s antidepressant effects,” said study lead Conor Liston of Weill Cornell Medicine.
In March, the Food and Drug Administration (FDA) approved esketamine (also known as Spravato) for people who did not respond to at least two other antidepressant treatments. The drug can only be administered under supervision by one’s doctor, and is said to relieve depression in just hours.
“There has been a long-standing need for additional effective treatments for treatment-resistant depression, a serious and life-threatening condition,” said Dr. Tiffany Farchione of the FDA.
Ketamine differs from traditional antidepressants by acting on glutamate, a chemical messenger in the brain, rather than the “monoamine” neurotransmitters (serotonin, norepinephrine, dopamine) that traditional antidepressants act on. Glutamate plays an important role in the changes that synapses undergo in response to experiences that underlie learning and memory, Scientific American explains.
A 23-year-old man suffering from depression, anxiety and other mental disorders shared his experience with ketamine infusion therapy with The Fix. “It helped with every aspect: anxiety, depression, psychosis. I know that’s not what it’s for, but in my case it changed everything,” he said.
However, medical providers caution that while ketamine shows a lot of promise, there’s still more research to be done on its long-term effects on mental health patients.
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