Since it was developed in 2016, we’ve blogged several times about esketamine—the isomer of ketamine being developed by Janssen Pharmaceuticals, designed to rapidly alleviate the symptoms of treatment-resistant depression. Esketamine, which will be administered intranasally, was granted breakthrough medication status by the FDA and fast-tracked for approval. And the time for approval is here.
For many women, giving birth is the most joyous event of their lives. But, every year, for more than 3 million women in the U.S., child birth results in the development of postpartum depression—and it can be devastating for mother and child alike. Most cases of postpartum depression are resolved within a matter of months, with such treatments as talk therapy, antidepressants, and ketamine infusions. However, some cases of postpartum depression can worsen in time, ultimately increasing the mother’s risk for developing chronic, severe depression.
There is no one-size-fits-all solution for depression. Even though 17% of people will suffer from depression over the course of their lives, modern medicine is still searching for a comprehensive solution. Traditional antidepressant medications are the first line of treatment for depression, though they are only effective for about 40-70% of patients, depending on what source you quote. In recent years, ketamine infusions have emerged as one of the most effective depression treatment available, offering hope for even the most debilitating cases of depression and providing relief to 70% of patients. Inspired by the way ketamine works to treat depression, several pharmaceutical companies are well underway developing new medications that may revolutionize the way we treat this mental health disorder.
More than 300 million people in the world suffer from clinical depression, but 50% of them will never seek treatment. Rather, these people suffer from such symptoms as sadness, inability to concentrate, and loss of appetite—with limited hope for improvement. Many individuals diagnosed with depression never admit that they need treatment in the first place. However, there are still others who recognize that they need depression treatment, but feel it is inaccessible to them.
In April 2018, we shared some promising information about a Yale School of Medicine study that found ketamine to be highly effective in reducing the symptoms of depression in a 16-year old patient suffering from suicidal ideations. After having declared himself “hopeless about the prospect of psychiatric improvement,” the patient was treated with ketamine infusions. His condition quickly improved to the point where he could be discharged from his inpatient psychiatric facility and resume his schooling. This study, however, was limited in scope, as it only presented the results from this one patient.
50 percent of patients diagnosed with depression do not respond to traditional antidepressants or psychotherapy, and a new study—the largest study of its kind—says it may have to do with genetics. Researchers from the University of North Carolina School of Medicine and University of Queensland studied the potential genetic risk factors of depression, and have linked 44 genes to the mental health disorder. Depression is the leading cause of disability for Americans between the ages of 15 and 44, and results in one million suicides annually.
Without getting into a discussion about the American healthcare system, it’s no secret that mental health treatment could stand to see some improvement. The National Institute of Mental Health estimates that 6.7% of Americans have suffered a major depressive episode. Still, depression is under-diagnosed and under-treated—especially in adolescents.
In August 2016, Janssen Research & Development—a Janssen Pharmaceutical Company of Johnson & Johnson—announced that an isomer of ketamine, called esketamine, had received Breakthrough Therapy Designation by the Food & Drug Administration (FDA). Similarly to ketamine, esketamine has shown huge promise as a depression treatment, especially for those experiencing suicidal ideation, or who have resisted other treatment methodologies.
When it comes to the relationship between chronic pain and depression, it’s very much a chicken-or-the-egg type of debate. The physical manifestations of depression—while hard to explain—can be quite painful: back pain, migraine headaches, etc. The mental manifestations of chronic pain can be equally troubling: stress, difficulty sleeping, low self-esteem, etc. Chronic pain and depression oftentimes work in a vicious cycle, where pain exacerbates the symptoms of depression, which, in turn, exacerbates the feelings of physical pain. And the cycle continues…
It’s a frustrating situation, to have this miraculous drug – a drug that is capable of changing and saving lives – so readily available, and yet so inaccessible. Without FDA approval, the overwhelming majority of insurance companies will not cover the cost of ketamine infusion therapy, leaving millions of Americans to suffer in the despair of severe depression. Private label ketamine clinics are operating around the country, but average prices of $500-800 per infusion are inhibitive at best. Even at our clinic, offering the lowest-priced ketamine infusions in the country, this potentially life-changing treatment is still not an option for many people.
Using ketamine as a treatment for major depression is a relatively new practice. While ketamine has been used as an anesthetic since the 1960s, its application as a depression treatment didn’t start to attract attention from researchers until 2006, with the first ketamine infusion clinics opening in the US around 2012. With a 70% success rate in improving the symptoms of depression, ketamine infusions have become increasingly popular, bringing hope to those who had none.