August 22, 2010

Ketamine: A Promising New Treatment For Depression


Ketamine is a fast-acting liquid anesthetic used mainly by veterinarians; it's also used in human medicine, even in children, because it doesn't depress breathing.

It's also an illegal club drug, known as "special K" or "vitamin K."

The street version is usually sold in a powder form that can be snorted or mixed into drinks, or dissolved into a liquid and injected.

It acts like LSD, causing vivid hallucinations in users and a sensation of floating outside their bodies.
Researchers at Yale University have discovered that a single dose of ketamine helps the brain to form new synaptic connections between neurons and can begin to relieve depressive symptoms in a little as 40 minutes.

In contrast, Prozac and other types of antidepressants can take anywhere from two weeks to a full month before they start to demonstrate any real results, in which benefits can only be seen in about a third of patients. This new antidepressant is now being tested in Canada with promising results.

Dr. James Kennedy, director of the neuroscience research department at the Centre for Addiction and Mental Health in Toronto states that ketamine might alleviate what has been known as a “major clinical problem”. The 2 - 4 weeks that patients await relief is a critical time where devastating outcomes, such as suicide, can occur because they begin to feel more energetic but depressive symptoms remain. Not only is there hope for those with difficult to treat depression, ketamine could actually save lives.
Earlier studies involving patients with "treatment-resistant" depression have found that those given a single dose of ketamine experience rapid and significant improvement in symptoms.

In a small study published earlier this month on patients with bipolar depression, 71 per cent of participants responded to ketamine versus six per cent who responded to placebo.
In addition to being fast-acting, studies show that relief can last for 7 – 10 days, according to professor of psychiatry and neurobiology at Yale, Ronald Duman, who calls ketamine a “magic drug”.

Duman also believes that this so-called magic drug may be able to reverse the effects of stress on the brain by repairing damaged connections between neurons caused by chronic stress.

Although ketamine may not be the ideal long-term solution for treating depression, it could certainly lead to the development of similar compounds that may produce the same effect, but can be more easily administered with less potential for abuse.

"Imagine someone who is in the ER (emergency department) and is highly suicidal. It would be a way to decrease the suicidal risk" says Dr. Pierre Blier, director of mood disorders research at the Institute of Mental Health Research and Canada Research Chair in Psychopharmacology at the Royal Ottawa Mental Health Centre, who has started using ketamine on some of his patients.

Sources:
'Magic drug' gives hope to bipolar patients - Ketamine is mainly used as an anesthetic by vets but shows promise in treating depression

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August 8, 2010

Deep Brain Stimulation May Delay Alzheimer's Disease

Researchers in Toronto, Canada have developed an experimental brain surgery that may delay the progression of Alzheimer’s disease. Six subjects with Alzheimer’s disease and an average age of 61 experienced this surgery called deep brain stimulation. The subjects continued to take their Alzheimer’s medication throughout the study.

Scientists implanted “electrodes in the brain's hippocampus, which plays a role in long-term memory. The electrical conductor acts as a pacemaker-like device in the head just beneath the skin. It is connected to a battery pack in the chest.”

Consequently, the mini-mental state exam, a cognitive test, revealed that half of the participants experienced a slow-down in the degenerative effects Alzheimer’s disease has on the brain, while the other half continued to decline in a manner typical of the disease’s progression.

While this new research has produced some promising results, deep brain stimulation is not a novel idea since it has been around for decades. For instance, Dr. Andres Lozano, a neurosurgeon at Toronto's University Health Network, experimented with its effects on Parkinson’s disease without success, unfortunately.

Although not all subjects experienced positive outcomes with this surgery, 64 year old, former city counselor from Brampton, Ontario, Robert Linton, recalled vivid memories of a day he spent fishing.
"I'm with my son," Linton recalled to reporters at Toronto Western Hospital. "I could see that muskie coming right at me as I was sitting in the chair, in Technicolor". "That's the power of touching a spot in your brain. I'm sold on it."
Currently, Lozano and his research team are recruiting roughly 50 people willing to install the stimulator. The plan is to activate half of the stimulators immediately and the other half only six months later all the while participants’ knowledge of its activation will remain unknown in order to truly test the benefits of the device.

Although, the true value of this device is not yet known, the actual retail cost if this treatment became available, would be between $15,000 and $20,000 per patient with a battery life of up to five years.

At the moment, I’m unsure whether I approve of this type of treatment. For one, results are insufficient therefore there is no real proof that the surgery will benefit enough people. Secondly, I am reminded of electroconvulsive therapy and I cannot get the image of Nurse Ratched delivering shock therapy out of my head…

Deep brain stimulation tested for Alzheimer's

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