What’s Next With New Ketamine Depression Drug? At IOL, a Study With Kids.

Ketamine
Print icon

While the nation is clamoring for more information about the new treatment approved by the Food and Drug Administration for depression, Drs. Andrew Winokur and Mirela Loftus are quietly working on the next application.

A nasal spray containing the active ingredient Esketamine — a chemical “relative” of the drug ketamine that has served as an anesthetic for decades – was approved for use against severe (treatment resistant) cases of depression in adults. Dr. Loftus, a child and adolescent psychiatrist, has been part of a research team affiliated with the Institute of Living testing various applications of the drug, marketed as Spravato, for depression.

The initial results in patients, she said, are astonishing,

“There are people who have been in our study for two or three years and every one of them has had the same story about how life-changing this is for them,” Dr. Loftus said.

Esketamine alters the chemical functioning of the brain in a manner that is different from antidepressant drugs currently on the market. Besides affecting the chemical shift in the brain that sparks depression, Esketamine works on the glutamate, affecting the synaptic plasticity. In other words, it potentially changes the connections or synapses in the brain that contribute to depression.

“The mechanism of action here is very different than any other anti-depression medication on the market now,” Dr. Loftus said.

A controlled substance, Esketamine must be administered in an approved clinic environment in which the patient is monitored for an hour or two for any adverse reaction. Such reactions, she said, can include elevated blood pressure and an altered perception of reality such as dissociation, dizziness, sleepiness or seeing double.

A variety of questions about the medication remain, however, and Dr. Loftus said researchers will continue to seek answers. For example, while there have been appropriate concerns about abuse potential related to the inappropriate use of ketamine (sometimes referred to as Special K), in carefully controlled clinical trials of Esketamine, problems with dependence or abuse have not been identified to date, although more research on this topic is needed.

“There has not been a long enough period of observation to know the answer to that,” she began. “But, why would I give a drug of abuse? It’s a completely different way of delivery and dosing than in the street.”

She is also involved in other research projects through the IOL’s Clinical Trials Unit, including one investigating the use of Esketamine in children and adolescents.

“The IOL is one of the few sites in the world using this in children and adolescents. We just recruited the second adolescent in the world for our study,” Dr. Loftus said, noting that the work is focused on children and adolescents presenting with suicidal thoughts, the most severe form of depression.

In addition, the IOL team is hoping to discover how to shorten the patient reaction time to the medication. Currently, Esketamine takes a few days to show an effect, as opposed to weeks for existing antidepressants. Further research is needed to see if there are certain conditions in which the effect would be even shorter, even just hours.

For more information about treatment for depression at the Hartford HealthCare Behavioral Health Network, click here. For learn more about the Institute of Living’s Clinical Trials Unit, click here.

 

 


What's New


Turning Recovery into a Vocation

On the darkest days of his week-long hospitalization at Natchaug, Robert Belenchia talked to people. Diagnosed with general anxiety, attention deficit hyperactivity disorder (ADHD) and major depressive disorder, Belenchia had checked himself into the hospital after isolating himself for weeks in his Norwich apartment. Many of the people around him...

Opioids illustration

Suboxone Therapy Added to Institute of Living’s Professionals Program

A grim lesson of the opioid epidemic is that addiction can happen to anyone, including working people. The Professionals Addiction Recovery Program at the Institute of Living helps those in the workforce successfully address addiction issues. An intensive outpatient group therapy program designed to facilitate recovery efforts, the Professionals Program...

The Science of Love

Teledildonics? Could Your Next True-Love Sexual Partner Be Non-Human?

Questions about men’s health, including sexual function? Click here to download your free informational guide.  With human brains wired to connect, the digital age has only expanded the ability to make liaisons of all kinds, from romantic to robotic. Robotic? Indeed, the science of love, lust and intimacy has expanded...

Lego Forma

The Latest in Adult Relaxation: Lego Forma?

Coloring books to help adults destress are so 2018. Lego wants to replace your crayons, colored pencils and adult coloring books as a means of relaxation. Meet Lego Forma, a set of the plastic bricks aimed at an adult market. Sounds great, right? But it has people asking if this...


For Adolescents, Hope After Heroin

Adolescents can – and do – get into trouble with addictions to opioids. Medication-assisted treatment is now available locally for this age-group, according to Patricia Rehmer, president of the Hartford HealthCare Behavioral Health Network. Q: Tell us about the local recovery program that the Hartford HealthCare Behavioral Health Network provides...