CHICAGO (AP) – went on the market for decades as an anesthetic for animals and people, was used as a powerful Painkiller during the Viet Nam war, and some use it as a recreational drug Sp ecial k. drug ketamine is now used as treatment for depression and conduct suicide without you even have official approval. They have opened up various clinics specializing in United States and promise instant relief with its “unique” dose of ketamine intravenously, in spray or pills. And desperate patients are spending thousands of dollars for a treatment that often is not covered by their health insurance, despite scarce evidence on the benefits and risks in the long term. Lauren Pestikas, a Chicago preschool teacher, suffered from depression and anxiety for a long time, and tried to commit suicide several times until it proved ketamine this year.
So far it has spent about $3,000 on treatment, but “every penny is worthwhile,” said the 36-year-old teacher. Pestikas said they felt much better for several weeks after each treatment, but the effect disappears and is difficult to pay another dose.
At the moment, the Administration’s food and Drug (Administration FDA) is not approved the use of ketamine for depression, although doctors can use it for that purpose.
This drug exists since the 1960’s and is widely used as an anesthetic in surgery because it will not suppress breathing. Compared with opioids such as morphine, ketamine is not as addictive or cause respiratory problems. And some studies show that it can reduce symptoms in a few hours in the most difficult cases. Their possible effects on depression were discovered in experiments with animals at the end of the 1980’s and early 1990s, which showed that glutamate, a neurotransmitter, could play a role in depression, and that substances such as ketamine that influence metabolic sequence of glutamate could function as antidepressants.
Conventional antidepressants such as Prozac inhibits the action of serotonin, another neurotransmitter type, and it usually takes weeks to months to effect, delay that can aggravate the desperation in the patients with severe depression.
The potential of the ketamine for almost immediate relief even if temporary is what makes it very striking, said Dr. Jennifer Vande Voor, psychiatrist at the clinic may which applies it since February to depressive patients.
“We don’t have many options that provide this type of effect. What worries me is, be reason for exaggerated attention”added.
Most studies suggest that ketamine is the most useful drug and usually safe to help patients in the short term that have not worked other antidepressants. These people are approximately one-third of the 300 million who suffer depression around the world. The drug “Yes has revolutionized the field”, changing the focus of scientists about the effects of the depression in the brain and showed that it is possible to relief fast, said Dr. Gerard Sanacora, psychiatrist at Yale University, which has research or has been Adviser of companies seeking the development of drugs with ketamine. But to become a standard treatment for depression is necessary much greater knowledge of the substance, he added. Last year, Sanacora co-authored a review carried out by a special team of the United States Association of Psychiatry to ketamine treatments for disorders of mood, which emphasized its benefits but said there is still “major gaps” in knowledge about the effectiveness and safety of long-term use. Most of the studies have been small, made in the field of research, and not in the real world. When supplied ketamine intravenous can increase quickly the heart rate and blood pressure, which could be dangerous for some patients. Ketamine can also cause hallucinations that some people have described as frightening.” There are some very real concerns,”Sanacora said. “We know that he can abuse of this drug, so we have to be very careful about how is developing this”. Dr. Rahul Khare, Chicago emergency medicine specialist, learned for the first time of the potential benefits of ketamine a decade ago while preparing to sedate a patient in order to correct him with a shoulder that is had dislocated it several times . That person also suffered from depression and anxiety.” He said: ‘ Doctor, give me the same as the previous time. During three weeks after I received it I felt much better ‘ “, recalled the physician.” Khare was intrigued and earlier this year began to meet with ketamine cases of severe depression in an outpatient clinic that opened a few years ago. Also joined the American society for physicians using ketamine, created a year ago and represents about 140 doctors, nurses, psychologists and others who applied the ketamine in cases of depression and other unapproved uses.
There are some 150 clinics where ketamine in United States compared with the around of 20 that existed three years ago, said the co-founder of the society, Dr. Megan Oxley is supplied.
According to Khare, this emerging field “looks like a new frontier” where doctors gather and compare notes. Khare has attended about 50 depression patients, among them Pestikas. It is common that these people are desperate for relief when other antidepressants will not work them. Some have lost their jobs and relationships due to severe depression, and the majority has found that ketamine allows them to operate, said Khare.El typical treatment in the clinic of Khare consists of six sessions of 45 minutes for about two weeks at a cost of $550 each. Some insurers will pay about half of that amount, including the cost of the visit to the clinic of Khare. Patients can receive dose “boost”. They must sign a consent of four pages that indicated that the benefits may not last long, the possible side effects are listed, and warns in bold letters that the treatment does not have the approval of the Government. During a recent session, its seventh, Pestikas rested in a white armchair and a nurse connected you the electrodes of a monitor heart rate and blood pressure. He grimaced when they introduced you a needle in the top of the left forearm. Khare arrived after another syringe that emptied a small dose of ketamine in a bag for serum that hung at the top of the Chair, then he lowered the intensity of lighting, closed the curtains and told you if I had questions, and if felt good.” No questions asked, just appreciation”, said Pestikas with a smile. The teacher heard music on his iPhone and looked psychedelic videos. He said was like a “controlled acid trip” with nice hallucinations. The trip ends soon to retire the serum, but Pestikas says that the rest of the day you feel calm and relaxed, and that the improvement in his mood can last for weeks. Several studies suggest that a single intravenous dose of ketamine much lower than the one used to sedate or for recreational use can help many patients get relief in four hours, effect that can last them a week or so. It is unknown how exactly the ketamine, but one theory is that, by raising levels of glutamate, helps nerve cells to restore connections disabled by depression, said Dr. Carlos Zarate, expert in ketamine and head of therapies experimental at the National Institute of Health Mental.Un small Stanford University study published in August suggests that ketamine can help reduce depression by activating receptors opioids in the brain. Janssen Pharmaceuticals and Allergan are among the companies that develop drugs similar to ketamine for depression. Janssen tops this list with its nasal spray esketamina. The company applied in September so that they authorize you the new drug. On the other hand, there are dozens of studies underway in search of answers to some questions of ketamine, including if repeated intravenous doses work best for depression and if there is any way to determine which patients could be more beneficiaries.
Until you have answers, Zarate said that ketamine should be a last resort for depression treatment when other methods have not produced the expected results.
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