Samuel Gershon: Ketamine, thw "new" breakthrough in the trestment of depression

Samuel Gershon: Some additional information

A recent report by Bryant KA, Altinay, Finnegan et al. (2019) entitled “Effects of Repeated Intravenous Ketamine in Treatment Resistant Geriatric Depression” does not prove or disprove the claims made for this product. However, I present it to bring up several points related to this topic:

1. The general claims for this product via IV or nasal spray are that Ketamine can
“produce a rapid antidepressant response in depression… even the same day”

2. The general view expressed about Ketamine is that it is particularly effective in the elderly, over 65, as targeted in this report.

3. This distinction is interesting as these cases are usually considered more difficult to treat

4. I am not aware of any double-blind studies to establish efficacy

5. It appears that the FDA may not have demanded double-blind studies

6. The reporting in the press on this subject suggests that treatment with Ketamine is a new breakthrough in the pharmacological treatment for depression

7. Reports in the press and elsewhere, quoting a number of experts, underline the importance of this “new” type of compound compared with all the previous types that have been marketed and, therefore, we may be at the threshold of new understanding of Depression

8. This is especially important as many experts have expressed the view that most or all of the previously marketed agents may not be better than placebo, at best.

I think that this presentation of Ketamine raises the need for some really serious examination of the situation and the many issues regarding the views expressed.

Reference:

Bryant KA, Altinay M, Finnegan N, Cromer K, Dale RM. Effects of Repeated Intravenous Ketamine in Treatment-Resistant Geriatric Depression: A Case Series. J Clin Psychopharmacol. 2019; Mar/Apr;39(2):158-161.

 August 8, 2019