Ketamine Eased Depression in Treatment-Resistant Bipolar Disorder

Business Week

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Ketamine Eased Depression in Treatment-Resistant Bipolar Disorder: But improvement

from anesthetic infusion was only significant for three days, researchers found.

HealthDay News, BusinessWeek, August 2, 2010.

Originally appeared at:

http://www.businessweek.com/lifestyle/content/healthday/641658.html

MONDAY, August 2 (HealthDay News)—The anesthetic drug ketamine helps ease

depression in patients with treatment-resistant bipolar disorder, a new study finds.

Depressive symptoms are a major part of bipolar disorder, which affects about four

percent of Americans at some point in their lives. There are several approved treatments

for bipolar disorder, but some patients do not respond to these therapies.

Ketamine acts on the brain’s glutamatergic system, which plays a role in information

processing and memory formation. Recent research suggests that dysfunction in this brain

system may contribute to bipolar disorder, noted Dr. Nancy Diazgranados and colleagues

at the U.S. National Institute of Health.

Their study included 18 patients with bipolar depression that didn’t improve when treated

with the medications lithium or valproate. Two-thirds of the patients were on psychiatric

disability and nearly all of them were unemployed.

The patients received an intravenous infusion of either ketamine or a placebo on two days

two weeks apart. The order of the infusions was randomly assigned.

The patients’ depressive symptoms were assessed before each injection and then 40,

80, 120 and 230 minutes, and one, two, three, seven, 10 and 14 days afterward. Within

40 minutes of receiving ketamine, the patients showed significant improvements in

depressive symptoms compared to those who received the placebo. The improvements

were most noticeable at day two and remained significant through day three.

At some point during the study, 71 percent of patients responded to ketamine and six

percent responded to the placebo. No serious side effects were reported during the trial.

The study, published in the August issue of the journal Archives of General Psychiatry,

provides evidence that the brain’s glutamatergic system may play a role in bipolar

disorder and that targeting it may lead to better treatments, the researchers wrote.

They also said that future research should explore how ketamine’s rapid effect on

depression can be maintained over the long-term.

Although ketamine has been used off-label as an experimental treatment for depression, it

has not been approved by the U.S Food and Drug Administration for that use, according

to the U.S. National Institutes of Health.

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