TUESDAY, Oct. 15 (HealthDay News) -- The veterinary tranquilizer
ketamine -- perhaps better known as the illicit "club drug" Special
K -- may be reformulated for use as an antidepressant, and
researchers report promising early findings.
The goal is to produce a ketamine-like drug without nasty side
effects, such as hallucinations. In this new study, which
researchers say is the most comprehensive of its kind, depressed
people who took the drug reported improvement over three weeks.
Although the findings need to be replicated in other studies,
"they do generate scientific data that will pave the way for future
research," said study co-author Sanjeev Pathak, senior director of
clinical development with AstraZeneca Pharmaceuticals, which is
funding the research.
It's still unclear whether the drug under development is safe or
could be used long-term.
The study, published online Oct. 15 in the journal
Molecular Psychiatry, also provides increasing evidence that
a new class of medications with similar effects to ketamine could
become available, said Michael Quirk, study co-author and director
of discovery and preclinical sciences with AstraZeneca.
In the United States, about 9 percent of adults report
depression, according to the U.S. Centers for Disease Control and
Prevention. Drug companies want to bring a new antidepressant to
the market because the existing medications don't work for
"The working rule of thumb is that a third of patients may get a response from the first treatment with an antidepressant, but a substantial proportion fail," said Dr. G. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. Alexander was not involved in the research.
Failure of the first antidepressant treatment typically requires
patients to try alternatives. That, of course, takes time,
especially because antidepressants often act slowly.
Enter ketamine, which is used legally as an anesthetic in
animals and people. It can put people in a trance-like state and
cause hallucinations, which has led to its illegal use in the club
scene, where it's known as Special K or K.
In recent years, researchers have started to investigate
ketamine as an antidepressant, and some physicians are prescribing
it off-label. It is legal in the United States to prescribe
government-approved drugs for nonapproved uses. Drug companies,
however, hope to produce a nongeneric version of a ketamine-like
drug that they can sell and promote.
Big questions remain regarding effectiveness, safety, long-term
use, cost and side effects. The point is to capture the positive
mood-altering properties without the negative side effects.
The new research consists of two Phase II studies, meaning
AstraZeneca is partway through the three stages of research that
drugs must go through for approval in the United States.
In the new studies, the researchers tested a drug called
lanicemine, which, like ketamine, disrupts how the brain processes
neurotransmitters. In one of the studies, 152 people with
depression were randomly assigned to take 100 milligrams or 150
milligrams of the drug or a placebo intravenously at three-day
intervals for three weeks.
The patients who took the drug were more likely to report
improvement in their depression during the three weeks they got the
medication and for several weeks afterward, although the side
effect of temporary dizziness was common. The hallucinations and
delusions associated with ketamine were not evident.
More research is planned. "We've got a long way to go before
deciding that this drug is adequately safe or effective enough that
it should be put on the market," Alexander said.
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