Transforming discoveries into innovative care
Cannabis; ketamine and brain imaging research focus on improving mental health treatment in real-time
Almost every day, there is another story in the news celebrating research advancements and discoveries that claim to bring us closer to better understanding the brain, and how it changes with mental illness.
For those already living with mental illness, however – especially those who are not responding to current treatments – it is not always obvious how (or when) these new discoveries might have a tangible impact on their own lives.
Because there is still so much that science does not know about the brain, the majority of mental health research stories that make it to our newspapers or tablets are related to new insights about how our brains function, rather than new treatments.
That is why we need translational research.
While basic (or fundamental) mental health research is critical in helping to produce an overall understanding of our brains and minds, translational research is designed specifically to transform new discoveries into real-world solutions that can directly improve care and quality of life for people with mental illness.
“The reality is that right now, there is a lot of trial and error when it comes to treatment for mental illness — we’re maybe only successful about half of the time,” said Dr. Zul Merali, President & CEO of The Royal’s Institute of Mental Health Research (IMHR), affiliated with the University of Ottawa.
“We need to approach research today from the perspective of how it can impact care tomorrow.”
With this perspective in mind, Dr. Pierre Blier, a clinician-scientist and director of the Mood Disorders
Research Unit at the IMHR has already been able to offer hope to some individuals with suicidal thoughts and treatment-resistant depression.
STUDYING THE EFFECTS OF “WONDER DRUG” KETAMINE
Blier has been studying ketamine’s effect on depression since 2011, and was the first clinician in Canada to give small doses of ketamine to patients.
Ketamine, an anesthetic agent that has been widely used for over 45 years, has proven to be a “wonder drug” of sorts for many patients who have been highly resistant to typical anti-depressants, according to Blier.
When delivered intravenously or with a nasal spray device in tiny doses, he said, ketamine has the ability to rapidly stop suicidal thoughts in 50 to 60 percent of patients. This is a significant number, considering that for many of these patients, little else has been effective.
Now, armed with the evidence that this novel treatment works, Blier plans to team up with IMHR colleagues Dr. Jennifer Phillips and Dr. Natalia Jaworksa to harness the cutting-edge technology at The Royal’s state-of-the-art Brain Imaging Centre to study the brains of patients who have been treated with ketamine. Through a better understanding of what brain circuits are responsible for ketamine’s rapid effects on depression and suicidal ideation, the team of scientists hopes to further optimize and target treatment.
Given its low cost, very limited side effects and extremely positive outcomes, Blier said that his next step will be to work with colleagues across Canada to increase accessibility of ketamine treatments to patients.
EXPLORING THE SAFETY AND EFFICACY OF CANNABIS IN TREATING PTSD
Although it is a large area of the IMHR’s focus, depression is far from the only mental disorder benefitting from translational research.
In light of Canada’s current legal framework for medical marijuana and upcoming legalization of cannabis for recreational purposes, for instance, researchers at the IMHR are poised to launch a new, multi-site study to test the safety and efficacy of cannabis in treating post-traumatic stress disorder (PTSD).
The rates of cannabis use among PTSD patients are currently quite high, as there is a popular notion that cannabis can help mitigate anxiety and related symptoms. However, there is also evidence that points towards adverse health effects of cannabis use, including effects on cognition or potential for addiction.
“In Canada and elsewhere, there are options for PTSD treatment and management, but at best, PTSD patients respond only partially to these treatments – and there are few evidence-based treatments out there,” said Dr. Florence Dzierszinski, director, Research Development and Partnerships at the IMHR.
Dzierszinski added that while there are widespread beliefs that cannabis can help alleviate some of the symptoms of PTSD, research data to back these anecdotal claims is lacking.
The outcomes of this research could be of particular significance to first responders, as well as veterans and active duty Canadian Armed Forces personnel, amongst whom PTSD is one of the most prevalent, chronic and disabling disorders.
Overall, said Merali, innovative research projects like these, where “care drives research and research informs care” have the potential to make the greatest impact on patient outcomes.
“At The Royal, we have the unique opportunity for scientists and clinicians to work together to discover new ways of treating illness, and directly evaluate how our innovations are impacting patients’ lives,” he said.
“It is when we can successfully translate knowledge from research into actual practice that we begin to see lives affected by mental illness transformed.”