Pubdate: Tue, 26 Aug 2014
Source: Toronto Star (CN ON)
Copyright: 2014 The Toronto Star
Contact:  http://www.thestar.com/
Details: http://www.mapinc.org/media/456
Author: Alex Ballingall
Page: A2

CLUB DRUG USED TO TREAT DEPRESSION

Toronto Sufferer Not Alone in Seeing Results From Ketamine

Patrick Cameron noticed a change in his brain on the third day of his 
treatment. The morning sun streamed through the trees above the 
Manhattan sidewalk, and for the first time in a long time, there was 
space in his thoughts to appreciate it.

"My mind wasn't crowded up," said the 31-year-old Torontonian who's 
been dogged by depression since adolescence. "I could just watch it 
and not have a thud of negative thoughts."

It was a welcome feeling that lingered for days, an elusive 
turnaround that Cameron credits to the innovative therapy he 
travelled to New York City to receive: a daily intravenous dose of 
ketamine, a popular club drug and widely used anesthetic that 
researchers say has the potential to help people like Cameron, with 
intractable cases of depression.

"This is the only thing that's worked," said Cameron. "I feel more 
like myself - much less pain and much less suffering."

Over the past decade, studies have suggested ketamine - known in some 
party circles as "Special K" - can effectively treat depression, 
especially when compared with the commonly used serotonin selective 
reuptake inhibitors (SSRIs). In a 2012 review of this research in the 
prestigious journal Science, Yale professors George Aghajanian and 
Ronald Duman said the emerging ketamine treatment is "arguably the 
most important discovery" - when it comes to depression - "in half a century."

That's no exaggeration, said Arun Rabindran, a University of Toronto 
psychiatry professor and chief of mood and anxiety disorders at 
Toronto's Centre for Addiction and Mental Health (CAMH).

"The data has been building up in the last 10, 12 years," he told the 
Star. "It's very promising. Very, very promising."

As it stands now, Health Canada hasn't licensed the use of ketamine 
for depression treatment, though there are ongoing clinical studies 
at the University of Ottawa and elsewhere examining its use. That 
means people like Cameron, who haven't had success with any other 
treatment and are reticent to try electro-convulsion therapy, have to 
head south and fork over thousands of dollars to try ketamine 
infusions. "I understand the need for caution, because it is a street 
drug and can be addictive," said Cameron, who paid $3,000 for six IV 
infusions of the drug. "I'm just worried about access to my 
treatment." Rabindran said he expects the treatments will become 
available as research progresses. It also remains costly and 
"inefficient," because the positive effects of ketamine treatments 
seem to only last a few days, and could offer diminishing returns 
when repeated over time, he said. A coming study that Rabindran is 
leading will look at other ways to take the drug: n! asally or orally 
instead of intravenously, he said. "We need to find something that 
will make the effect of ketamine more sustained."

Still, there's already reason for excitement, he said. This hope for 
ketamine stems from how hard it remains to effectively treat cases of 
major depression. Regularly prescribed SSRIs, such as Prozac and 
Zoloft, can take weeks or even months to kick in. Even then, said 
Rabindran, about 20 per cent of patients don't see any effect from 
these drugs. Ketamine, on the other hand, "seems to be addressing 
these issues well," said Rabindran. It is very quick acting - effects 
are typically seen within 48 hours - and it is proving effective for 
people resistant to the currently predominant treatments. Some 
studies have concluded 50 to 75 per cent of these patients have seen 
benefits from ketamine, Rabindran said. "It's much faster than 
regular antidepressants and works when regular antidepressants don't 
seem to work," he said. Rabindran said the reason for this is that 
ketamine seems to be more effective at "enhancing" receptors in the 
brain that are blocked up when some! one has depression. "(Ketamine) 
repairs the damage that has happened to the brain cells because of depression."

In terms of side effects, the primary concern is what Rabindran calls 
the "relaxed dissociated state" that comes during the ketamine 
treatment and disappears within a few hours. Essentially, the patient 
is tripping out (Cameron said he felt "spacey" and detached). This 
can be frightening for some people, said Rabindran, who added that he 
feels such concerns are outweighed by the power of ketamine to soften 
depression quickly.

"When someone is going to kill themselves, this is a relatively minor 
problem," he said.

As for Cameron, he said he might return to the U.S. for treatment in 
a few months, as the clinic suggested, hoping to keep his depression 
at bay until he's able to receive the therapy in his home country.
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MAP posted-by: Jay Bergstrom