A new, fast-acting antidepressant that works like the infamous club drug ketamine could elevate mood in just 24 hours, researchers say.
Though the drug is still in the early stages of development (to this point it has only been tested on animals), it shows promise for the treatment of a mental health disorder experienced by least 10 percent of American adults. It also solves a significant problem with antidepressants currently on the market: all approved depression drugs can take up to a month to work, meaning patients must wait before feeling any significant relief. In addition, there is no one-size-fits all antidepressant; finding the right drug for the right patient can sometimes be an issue of trial and error, and this weeks-long lag time for pharmaceutical benefit further prolongs this process. So an antidepressant that does not take so long to work could help people more quickly and streamline drug selection.
While depression is often a long-term illness, there are also shorter-term cases for which a month-long wait just doesn’t make sense. Sometimes doctors prescribe these patients a medication from a class of anti-anxiety drugs called benzodiazepines, such as Xanax, but this is far from ideal as they only treat some symptoms—such as constant worrying—and are highly addictive.
Also, there hasn’t been a “fundamentally different antidepressant medication for decades, perhaps even 30 years,” Jefferey Talbot, associate professor of pharmaceutical sciences at Roseman University of Health Sciences who is researching this new drug, tells Newsweek. “They’re good drugs and they’re relatively safe and well tolerated, but they’re surprisingly ineffective in a large number of patients.”
A new medication, Talbot explains, might be able to help those resistant to current therapies.
Talbot, who is collaborating with researchers at Duquesne University and the National Institute on Drug Abuse, says scientists worldwide have become increasingly interested in the idea of a fast-acting antidepressant. Some teams even tried treating some depression patients with ketamine—a veterinary anesthetic that became a prominent recreational drug during the 1990s rave scene (street name: “Special K”) because of its hallucinogenic properties.
“[Ketamine] provides anti-depressant relief in about 24 hours,” Talbot says, but “it has abuse potential and from a therapeutic standpoint, it doesn’t work well orally.” Talbot says this ketamine research ultimately tipped off researchers to the idea that drugs “that act like it from a mechanistic standpoint” could have a similar therapeutic effect.
That mechanism prevents the brain from breaking down three key neurotransmitters: serotonin, norepinephrine and dopamine, which, when released into the brain, are known to generate feelings of positivity and happiness. In brain science parlance, this mechanism is called “reuptake inhibition.” Most antidepressants on the market prevent the reuptake of one or two but not all three. So a ketamine-modeled solution that works on all three could be a game-changer.
Talbot is quick to point out that his team isn’t the first to identify this drug or argue for its therapeutic potential, but thinks “the real novelty and potential benefit of the drug” identified in their research is that it provides “both short-term and long-term relief.” For patients, this would mean that the same drug addressing their symptoms almost immediately could also be used for long-term relief.
Daylina Miller, a 25-year-old journalist in Central Florida who has depression, says a fast-acting antidepressant could have helped her get back on track more quickly in college.
Miller had long dismissed her worried, sad feelings, thinking “I was your typical angsty teenager,” but her declining mood came to a crux in college. While from the outside it may have seemed that everything was going great — she was in school, in a supportive relationship, and able to afford a car — she often didn’t even have the energy to get out of bed and missed almost every session of an early-morning class. She felt as if she were stuck under a “black cloud,” descending further and further into pessimism and hopelessness.
The issues prompted her to see a doctor. Based on her symptoms and family medical history, the doctor diagnosed her with depression and prescribed Prozac, which works to prevent the reuptake of serotonin. The doctor did apprise Miller that the medication might not work for four weeks—and Miller says that knowing the timeline made the wait tolerable. Still, she was “frustrated” by the process.
“If there had been an option for something that could have helped me in a day or two, I would have absolutely jumped on it,” she tells Newsweek. “It took everything in me to go to class and to study. But I didn’t do as well as I could have. I could have gotten straight As but I was getting Bs and Cs.”
Some aren’t as enthused.
Dr. Peter Kramer, psychiatrist and faculty member of Brown Medical School who wrote Listening to Prozac, a groundbreaking 1993 book that explored the philosophical ramifications of these drugs, was a bit skeptical of the premise that a fast-acting antidepressant is watershed. He acknowledges that current antidepressants typically take between two and four weeks to work fully. At the same time, says Kramer, some studies show that certain antidepressants can have minor impacts on mood within “three to four hours.”
“Reversing depression takes a while,” he says, but with antidepressants “it does seem as if there are some very early effects.”
Another caveat with fast-acting antidepressants: clinical depression is a class of illnesses that takes time to diagnose and treat. A patient must feel “discouraged, sad, hopeless, unmotivated, or disinterested in life in general” for more than two weeks before a doctor can determine whether it’s merely a case of the blues or clinical depression, according to the Anxiety and Depression Association of America. Even with shorter-term cases, mental health professionals generally agree that the most effective method of treatment for any condition requiring medications includes psychotherapy. A 2008 study showed that combination therapy can lead to quicker remission from chronic depression than either psychotherapy or medication alone. At the same time, one shouldn’t dismiss the possibility of fast solace from symptoms if it enables the patient to seek help and possibly stave off the most severe result of depression, suicide, which remains the 10th leading cause of death in the U.S.