Clubbers’ drug ‘Special K’ now treating depression
John was suicidal, depressed and unresponsive to other treatment when he was accepted into a drug trial at the Royal Ottawa Hospital that he says saved his life.
The Ottawa father of three, whose name is being withheld at his request, is one of a growing number of suicidal patients whose lives have been turned around through experimental treatment with a drug that has another life as a street drug known as Special K.
Ketamine, a long-used anesthetic that has been used as a daterape drug, is now being studied for its ability to rapidly stop suicidal thoughts in a high percentage of patients — including in John — when given intravenously.
“I was suicidal. I was desperate,” the 50-year-old man said.
After intravenous treatment with ketamine, he said, he started to feel better almost immediately. Although he has had some relapse of depression, it is more manageable, he said, because his suicidal thoughts are gone.
“I am able to spend time with my kids, to at least feel like a normal human being. Before, I was one step away from getting into another world. Now those thoughts don’t bother me.”
Dr. Pierre Blier, director of the mood disorders research unit at the Royal and a professor at the University of Ottawa, calls ketamine “the biggest breakthrough since the introduction of antidepressants.”
It is something he has been studying for its effect on depression since 2011. More recently, he has also been looking at the drug ’s impact on patients with suicidal ideation, research partly funded by the Ontario Brain Institute and the federal government.
Among those patients, about 90 per cent have reported a decrease in suicidal thoughts.
“Our work has shown a direct effect,” Blier said.
Blier’s is the only Canadian centre doing research into ketamine delivered intravenously, but it’s also being studied in other parts of the world. He is also researching a nasal application of the drug he said is showing positive results and could be on the market as early as 2019.
Blier’s assessment of ketamine as the biggest breakthrough since antidepressants reflects its impact on patients for whom little else has worked. For patients resistant to other drug treatments, it’s an alternative to one of the only remaining treatments — electroconvulsive therapy, which has potential longlasting side-effects, is more invasive and requires hospitalization.
“Some of our patients have failed many treatments. This gives us the opportunity to not hospitalize them. It has basically changed their lives.”
In 2013 Blier wrote in the Journal of Psychopharmacology about the use of ketamine on a patient. The 37-year-old mother was suicidal and resistant to other treatments. Rather than turning to hospital admission and electroconvulsive therapy, they administered ketamine to her. She immediately reported a dramatic decrease in suicidal thoughts and was able to return home, on a dose of lithium, Blier wrote.
The effects of the drug are dramatic, but not long lasting and can begin wearing off within a week or less. As part of the trial, patients are given repeated doses, depending on how long the effects last. Some patients are able to maintain the effect and receive therapy or other drugs to remain in remission.
Although the drug appears to be safe for most otherwise healthy patients, Blier recommended advanced cardiac life support be available when patients receive the treatment. He also cautioned that, because it is a street drug, there is a risk some patients might feign or embellish depressive symptoms and suicidal ideation to obtain the treatment.
“Clinicians must be vigilant to the potential for drug-seeking behaviour.”
Blier is planning more research into the effects of ketamine on animal and human brains.
Ketamine has the potential to be a game-changer for patients with few other options, and it could be the first among new drugs that change the way such patients are treated.
John, whose life at the time was anything but, recalls an “extreme feeling of peacefulness” when he was first administered ketamine. He had other treatments after that, including some “extra infusions” when he felt the depression and suicidal ideations were returning.
His depression has lingered, something he is working on, but he no longer lives with thoughts of suicide.
“These thoughts don’t bother me anymore. I am extremely grateful.”