Ketamine trialled as new hope to prevent recurrent depression

Researchers from the Department of Psychiatry at Trinity College Dublin are trialling a potential new treatment option for people who suffer from repeated episodes of depression. The team are investigating whether the children’s anaesthetic ketamine, which has recently been shown to have antidepressant effects, could help people who recover from severe depression to remain well.

Around 200,000 people in Ireland suffer from depression every year with about 6,000 requiring hospital admission. Despite intensive treatments, including existing medications and talking therapies, staying well after recovery remains a key problem – up to 60% of people will become unwell again within the first six months of recovering from an episode of depression. In fact, people with recurrent depression experience from five to nine episodes in their lifetime. Currently there are very few effective strategies to prevent someone from relapsing after they have recovered from an episode of depression which is why this work funded by the Health Research Board and the Medical Research Charities Group is so important.

Professor Declan McLoughlin, Research Professor of Psychiatry at Trinity, and his team at St Patrick’s Mental Health Services are running a number of innovative trials to see if ketamine can offer hope to people who suffer from repeated episodes of depression. Ketamine has been used as an anaesthetic for many years but, more recently, has been shown to give almost immediate relief from symptoms of depression. It had not, however, been tested for preventing depression relapse.

In one study, the KEEP-WELL Trial, people who have had electroconvulsive therapy (ECT) for severe depression and have recovered (about 70% of people who have the therapy), can receive infusions of ketamine or placebo during the initial weeks after recovery. A second study, the KINDRED Trial, invites people admitted to hospital with recurrent depression to have ketamine infusions once recovered from depression using standard treatments. 

Professor McLoughlin explains; “We‘ve seen from research over the last number of years that ketamine can be a powerful antidepressant. We also know that people who have just recovered from depression are at very high risk for another episode. In our own studies, we aim to see whether it’s possible to harness that powerful antidepressant action of ketamine to prevent future depressive episodes in people who have recently recovered from depression. This has never been done before.” 

“Depression is the most common reason in the EU for long-term sick leave and disability. Indeed, according to the World Health Organisation, depression is the leading cause of disability worldwide. It is therefore a public health priority to not only recognise and treat depression but also to keep people well afterwards.”

Ketamine works differently to currently used antidepressants and exactly how it causes its antidepressant effect is not yet known. It may change dysfunctional brain cell pathways and connections, a process called neuroplasticity. Professor McLoughlin’s team are also analysing patient blood samples to conduct studies on examining how ketamine works to treat depression.

The research team are also looking for healthy volunteers who are needed to complete mood and memory assessments to maintain the scientific quality of the studies. These volunteers do not receive any treatments or medications. Please contact thekeepwellstudy@gmail.com. More information is available at: https://www.tcd.ie/medicine/psychiatry/research/depression/

The researchers have recently published a paper describing the protocol for the KEEP-WELL study which is available here: http://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-016-0080-0

More information is available at: www.ClinicalTrials.gov  Identifiers: NCT02414932 and NCT02661061

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Yolanda Kennedy, Former Press Officer for the Faculty of Health Sciences | publicaffairs@tcd.ie | +353 1 896 4168