Please login to the form below

Could ketamine be the next big thing in depression?

Account Executive Will Frostick discusses the established treatment model for depression and its limitations, as well as a new entrant poised to revolutionise the field – ketamine.
Depression is a leading cause of disability worldwide and with more than 1 in 10 suffering from symptoms, it is likely to affect many of us in some way over our lifetimes.However, despite the large public health burden of depression, therapeutic discovery in this field has lagged significantly behind other areas of medicine and our ability to combat depression and relieve its symptoms is limited.

Antidepressant treatment: a history

For the last 50 years, antidepressant research and medicine has been dominated by the monoamine hypothesis. This theory links depression to the depletion or perturbation of signals from certain neurotransmitters, such as serotonin and norepinephrine, whose chemical structures belong to a class of molecules known as monoamines.The theory suggests we can reduce depression by stn ever since.Like many scientific breakthroughs, the monoamine hypothesis was found by chance. Doctors noticed that tuberculosis patients treated with isoniazid showed signs of improved mood.Isoniazid is antituberclular but it also interferes with monoamine metabolism, slowing neurotransmitter breakdown once it is released. As a result, more monoamines are left active in the brain for longer periods of time. It was also observed that reduced monoamine levels could predict suicidality.Based on this evidence, the monoamine hypothesis has risen to the forefront of depression science.

Stagnation, stagnation, stagnation

Since the isoniazid discovery, an abundance of antidepressants based on the monoamine hypothesis have entered the market.While there is some variance in the molecular mechanism, these drugs still work on the same general principle. For example, Prozac (fluoxetine) is a selective serotonin reuptake inhibitor, or SSRI.SSRIs inhibit brain cells’ natural process of ‘vacuuming-up’ (reuptake) a specific monoamine (serotonin). Much like isoniazid, this has the overall effect of increasing the amount of monoamine left hanging around (see figure above).This general model has been used to treat millions of patients and was the first major breakthrough in depression medicine. However, there has been little to revolutionise the field in the half century since.Nearly all the treatments entering the market have been ‘me too’ drugs, and while second generation therapies have demonstrated improved tolerability and more specific biological actions, the approach has failed to generate notably more effective therapies.Response rates have stagnated over the years and tricyclic clomipramine, one of the oldest antidepressant drugs, remains one of the most effective.

What are we missing?

There is more to be concerned about than inertia. Although antidepressants reliably increase neurotransmitter levels in the brains of patients, this does not always translate into symptom relief.Response rates are often only marginally greater than placebo, and much of the symptom relief can be linked to an active placebo effect. Even though neurotransmitter levels rise within hours, it can take 4-6 weeks to see any therapeutic benefit (although not to see the side effects). Further still, pharmacological depletion of monoamines in healthy volunteers does not cause depression either. These criticisms call into question the presumption that depression is caused by an impairment of monoaminergic neurotransmitter function. This clearly suggests the monoamine model is insufficient. Limited efficacy combined with painstakingly long onset times are letting down vulnerable patients. Fortunately, a new approach is emerging and excitement is building about “the most important breakthrough in antidepressant treatment in decades”. Ketamine as a depression treatment may seem unorthodox to some but the early results are remarkable.

Download the full article from Blue Latitude Health

3rd August 2017



Company Details

Blue Latitude Health

+44 203 328 1840

Contact Website

Blue Latitude Health
Crusader House
145-157 St John Street
United Kingdom

Latest content on this profile

Big data, privacy and the rise of genomic testing
Blue Latitude Health speaks to Johan Christiaanse, Marketing Director at BGI, to find out how the medical profession can overcome one of the major barriers to precision medicine – big data.
Blue Latitude Health
Lynch syndrome: a patient perspective
Blue Latitude Health intern Costantino Ciotti gives an insight into life with Lynch Syndrome, a genetic condition associated with colon cancer. Here he explores the patient’s perspective, including treatment options, and gives his advice for healthcare professionals diagnosing patients with a genetic disease.
Blue Latitude Health
What does programmatic advertising mean for your pharma marketing strategy?
Senior Associate Consultant Jiayi Chen explains the benefits and pitfalls of programmatic advertising and reveals how it can impact return on investment in your marketing campaigns.
Blue Latitude Health
How to measure marketing success: profit vs ROI
Measuring marketing activity is proving to be a major challenge in pharma. Here, Senior Consultant Paul Townley-Jones explores the meaning of success and gives his tips for measuring efficiency and effectiveness, along with the formula for calculating profit and ROI.
Blue Latitude Health
Perspective on biotech leaders
In the latest issue of Perspective magazine, seven industry trailblazers reveal the trends, challenges and opportunities they anticipate in the biotech sector, from empowering patients to deciphering big data.
Blue Latitude Health
Global customer research in healthcare: 10 tips for capturing insights that matter
What makes a strong brand? One global core coupled with sensitivity to regions and countries. In part two of our series on customer insight and behaviour change, we share our tips on optimising global customer research projects to ensure you get the balance right in an efficient way.
Blue Latitude Health