june 2016

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Innovative Research in Depression

An innovative study to investigate the potential benefits of ketamine for relapse prevention in depression is continuing at St Patrick’s University Hospital with researchers from the Department of Psychiatry.

Depression affects up to 20% of people in their lifetime and can be a severe, debilitating illness. It is the most costly brain disorder in Europe, accounting for 1% (€118 billion annually) of the total European economy. Indeed, depression is currently the second largest cause globally for years lived with disability.

Nearly one-third of people who experience depression do not achieve response with their first antidepressant treatment. While up to 70% of such treatment-resistant patients will recover fully with electroconvulsive therapy (ECT) Professor Declan McLoughlin’s research group recently reported that relapse rates following successful ECT are high  - nearly 40% of patients relapse within six months of completing a course of ECT. In addition, such high relapse rates are seen for all patients with treatment-resistant depression, irrespective of what treatment they have received. There is an urgent need for better relapse prevention strategies.

Ketamine, a competitive NMDA-receptor antagonist, long used as an anaesthetic, has been shown in clinical trials to have a rapid, robust, antidepressant effect in acute depression. Ketamine activates neuroplasticity pathways with changes noted in BDNF, mTOR and other peripheral biomarkers. Professor Declan McLoughlin’s group have designed two pilot clinical trials of ketamine to assess the possibility of harnessing ketamine’s neurotrophic effects to meet the urgent clinical need for depression relapse prevention strategies. These trials are ongoing at St Patrick’s Mental Health Services. In addition, the group is undertaking trials of cognitive function and biomarker studies to fully assess ketamine’s effects. Healthy volunteers with no lifetime history of mental illness are urgently required as a control group for cognitive assessments and biomarker studies – there is no intervention and assessments take one hour on two occasions. Interested parties are invited to email thekeepwellstudy@gmail.com.

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