For patients with severe depression who are stubbornly resistant, ketamine is increasingly looking like a solution. Years of research have suggested the potential for treating dissociative anesthetics where other medications have failed, and electroshock therapy promises benefits with far fewer risks.
Despite the excitement, the drug’s powerful psychoactive effects have made it difficult to separate the promise from the hype. How can you conduct a blind test for a drug that so blatantly separates the mind from the body?
Researchers at Stanford University School of Medicine put ketamine to the ultimate gold standard test, using patients under general anesthesia while they were unconscious.
Their randomized, triple-masked study found that a single dose of ketamine was as likely as a saline infusion to improve the next day’s mood in patients diagnosed with moderate to severe depression. found.
“I was very surprised to see these results. I spoke to some patients in particular who said, ‘It’s changed my life, I’ve never felt anything like this before,’ and they were very surprised to see this result. was.” To tell “It’s important to note that the study’s lead author, Boris Heifetz, an anesthesiologist at Stanford University School of Medicine, said:
Developed in the 1960s Ketamine has a considerable history in medicine in the search for new anesthetics and analgesics.Still used in emergency medicine fast and reliable While it is a means of treating patients in pain and extreme distress, its dreamy and dissociative effects have led to its illegal recreational use. It also rose slowly For many years.
Over the past decade, its potential as an antidepressant has attracted renewed interest in the pharmaceutical field. Clinically speaking, relatively small amounts of psychedelic substances improve the mood of ratsEven if you only took one dose.
Potential explanations were quickly identified. various anatomical and animal model studies have linked the effects of compounds to changes in functional connectivity and activity in regions associated with depression.
Subsequent studies of patients diagnosed with severe depression reported significant reductions in suicidal thoughts and improved mood, leading the FDA to approve ketamine as a nasal spray for treatment-resistant depression. It’s arrived.
Beneath the hopeful headlines, it remains possible that the experience of taking a powerful psychoactive substance itself may be important to its therapeutic effects.
To “hide” the drug’s mind-altering effects from other possible mechanisms, Heifetz and his team assigned 40 surgical patients to one of two groups. One to administer ketamine under general anesthesia, and one to administer saline.
Neither patients, researchers, nor care staff knew which treatment they received. Two weeks after the surgery, at the end of the trial, more than a third of his recruits could correctly tell which group they belonged to.
However, in the days following the infusion, many patients in both groups showed improvement in mood. Montgomery Asberg Depression Rating Scalesuggesting that the benefits of ketamine may be primarily due to general medical psychology.
This does not necessarily mean that ketamine is completely ineffective in treating depression, but it does suggest that the effects it has may be more a result of general experience than biochemical tweaks. suggests.
“We also considered the possibility that surgery without ketamine and general anesthesia may have an antidepressant effect,” the researchers wrote. write. “However, our review of previous studies measuring perioperative depressive symptoms strongly suggests that this is not the case.”
The brain is a complex engine, and depression itself turns out to be a complex phenomenon that defies simple explanations such as “chemical imbalances” or dysregulated circuits.
Just as mixing MDMA with therapeutic drugs has been shown to provide a healing experience for PTSD patients, dose-controlled ketamine in the right environment can help severely depressed patients find a way forward. may be useful.
“There’s definitely a physiological mechanism, and when you plant hope, something happens between your ears.” To tell Heifetz.
This study natural mental health.
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