Ketamine, an anesthetic and animal tranquilizer that is also often used illegally as a recreational drug, could be a safe and effective way to help elderly patients with treatment-resistant forms of depression, claim the authors of a new American Journal of Geriatric Psychiatry study.
In what The Independent calls “the world’s first randomized control trial” to investigate this use of ketamine, University of New South Wales professor Colleen Loo and her colleagues reported that the drug could have “truly remarkable” benefits for depression patients over the age of 60.
As part of a small, double-blind, controlled pilot study, Loo’s team recruited 16 participants at least 60 years of age who had treatment-resistant depression. Over the span of five weeks, each of the patients were treated using ketamine in separate sessions, with a placebo randomly given to them at some point during that period, according to the Daily Mail.
After the initial five-week period, the patients were then given 12 doses of ketamine at various times over a six-month span, and their mood and overall health were monitored throughout, the UK newspaper added. Eleven of the sixteen participants reported that their condition improved while they were undergoing treatment, and six months later, 43% said that they no longer were experiencing symptoms of depression.
Furthermore, five of the patients said that they were free of symptoms when receiving less than the standard 0.5mg/kg dose of ketamine, the researchers reported. Based on the results, Loo told The Independent, the study “has shown ketamine can be used safely in the elderly and it tends to be effective.”
Dose-titration method appears to be most effective
While the results are similar to those that have been observed in younger patients, co-author Dr. Duncan George from UNSW Sydney told the Daily Mail that the they are nonetheless significant because severe depression can be more difficult to treat in those over the age of 60.
“Elderly patients with severe depression face additional barriers when seeking treatment for the condition,” Dr. George explained. “Many medications may cause more side effects or have lower efficacy as the brain ages,” and older depression patients are “more likely to have co-morbidities like neurodegenerative disorders and chronic pain, which can cause further complications.”
Loo told The Independent that the findings suggest that a dose-titration method – a technique in which a doctor determines the amount of a drug that reduces symptoms to the greatest possible degree while avoiding potential adverse side effects – appears to be the most effective method of using ketamine to treat depression in the elderly. Each of the doses administered in the study had been personalized for each individual patient, according to the study authors.
Loo added that the results were “a promising early piece of the puzzle,” but emphasized that the risks of using ketamine in this manner are not fully understood at this time. She and her research colleagues said that additional studies need to examine the drug’s potential side effects, including its effect on the liver, and that they are currently planning a larger-scale version of the trial.
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