Ketamine and smiley pics - the ultimate depression cure?
Alexa, play "Shiny Happy People"
words Megan Wallace
Over the past few years, ketamine has undergone the biggest rebrand we've seen since low-rise jeans. Once solely considered a party drug, hurling people downwards into k-holes of silence and distance, years of research pointing to the substance's anti-depressive qualities have become public knowledge. And it's been a long time coming! The first randomised trial indicating ketamine's positive impact on mental health was published by Yale School of Medicine all the way back in 2000. Yet it took until 2019 for the US Food and Drug Administration (FDA) to approve a ketamine-derived drug for mental health purposes.
The drug that was approved three years ago is a nasal spray which, admittedly, has been met with scepticism in the medical community. However, ketamine is being optimistically prescribed off-label in legal, private ketamine clinics across the US and even in the UK. In these centres, ketamine is administered intravenously as an infusion and has been shown to be a fast-acting antidepressant, particularly efficient for combatting treatment-resistant depression and suicidality. This is significant when we take into account that traditional antidepressants like SSRIs (often better known by their brand names Prozac and Zoloft) take weeks to kick in and don't work for everyone.
In the scientific community, the positive outcomes from ketamine trials seems pretty encouraging. Among them? The results from a double-blind, randomised clinical trial published in American Journal of Psychiatry which has zoned in on a way to make the impact of ketamine treatment last longer. Normally, the treatment wears off in the weeks following an infusion, forcing patients to return for follow-up sessions which can be expensive. However, the study found a surprisingly low cost and efficient way to combat this.
After injecting a dose of ketamine into a participant, the team used automated computer-based training to influence the patient's self-perception. The computer showed words like “sweet,” “loveable,” and “worthy” on a screen, followed by pictures of the patient and images of other people smiling.
And it was shown to be effective in making the patient happier - here's why.
“Using simple conditioning during the period after ketamine treatment, when the brain is receptive to soaking in new information, allows us to go after key features of depression,” said Rebecca Price, Associate Professor of Psychiatry at the University of Pittsburgh School of Medicine. In basic terms, the scientists realised that patients were significantly more receptive to positive vibes when they were high and in the days straight after. Relatable!
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To give you some more details, the clinical trial was based on 150 adults with treatment-resistant depression. One group received a ketamine infusion followed by eight 20-minute computerised positivity training sessions over four days - those images of happy people smiling at them and super-uplifting words - while another was given a non-therapeutic version of the computer tasks. A final group was given the positive messaging but given a placebo injection instead of the ketamine. In the month afterwards, the group that received ketamine and positivity training said that they felt fewer depression symptoms over a longer period than the other two groups.
While we're not sure how we feel about a computerised hypeman being at the centre of mental health treatment, we guess it beats an NHS waiting list for a flesh-and-blood counsellor.
However, this isn't the only positive development in ketamine land.
Scientists have long been debating why, exactly, ketamine works to combat depression - with some thinking that the very act of tripping is what makes ketamine such an effective depression treatment. However, some scientists have been able to debunk this, with a study published in late September this year showing that researchers have been able to create a compound targeting specific 5-HT2A serotonin receptors in the same way as ketamine but without the psychedelic effects. That means, simply, they've taken the high out of the drug in order to deliver solely feel-good vibes.
While the patients for this study have been lab mice so far, it could prove to be a major breakthrough. Essentially, it's led to hope that scientists could create ketamine-like substances without psychedelic properties to treat depression as a way to circumvent the legal and logistical issues currently faced by ketamine. Who knows, maybe one could even be available on the NHS some day...