New Scientist Issue 2939
Mirages Of The Mind
Date 19th of October 2013
Ketamine has been one of the significant developments in the treatment of treatment resistant depression. Thought to help the production of the neurotransmitter glutamate which is a key component in helping link neurons together. Ketamine originally showed promises by having almost imitate effects in reveling depression in people (around 60% of the relativity small sample size of 72 people ) of which no other treatment had worked however ketamine has adverse side affects. Ketamine was originlay developed as a horse tranquilizer but has also found popularity as a party drug and so it comes as little surprise that one of the side effects are hallucinations and other psychotic symptoms thus making it unsuitable for general use.
A team lead by Gerard Sanacora of Yale University and Mike Quirk of pharmaceutical firm AstraZeneca looked for an alternative compound, they decided to test lanicemine a drug originaly developed to treat epilepsy and targets the same receptors as ketamine.
The team gave 152 people with moderate with severe depression and a history of poor response to anti depressants either lanicemine or a placebo three times a week for three weeks (they were allowed to continue taking medication they were already on for ethical reasons ).
Before and after the paitents levels of depression were rated on a 60 point scale. After 3 weeks those taking lanicemine were less depressed on average by 13.5 points 5.5 points higher than those on the placebo. The results were still at there hightened levels two weeks after the final dosage had been given. The only common side effect of the drug being dizziness.
'what this tells us is some of the concerns around ketamine might not be such a big problem as originally thought' says Quirk 'There are ways around them with the right molecule'
The only downside determined from the experiment was that lanicemine didn't have as an immediate effect as ketamine. The effects of Lanicemine took up to 3 weeks for effects to be seen as opposed to ketamines almost instantaneous effects, however a smaller scale study with 32 people not taking other depression related medication showed the effects to be more quickly present and so it is though that delayed effects could be down to the taking of other medications.The effects of lanicemine were also more pronounced in the study with patients on just that drug.
Even though these are small steps there are no the less essential. By 2020 the world health organisation estimates that depression will be the leading cause of disability in the world. This makes these studies especially important as around a third of people do not respond to current medication. The hope is that ketamine-like drugs will offer a real alternative as they work via a different chemical (glutamate) in the brain which is thought to stimulate regrowth of the brain cells that may have atrophied (of body tissue or an organ)waste away, especially as a result of the degeneration of cells, or become vestigial during evolution.)
'This could be revolutionary the first new drug treatment for depression in years says former Uk government adviser David Nutt
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