A new form of ketamine tablet has shown promise in reducing symptoms of severe depression.
- When ketamine is given by injection or nasal spray, it causes side effects (a feeling of choking, sedation, and increased blood pressure).
- Ketamine extended-release tablets, at a high dose (180 mg), reduced symptoms in adults with treatment-resistant depression.
- Tolerance to the drug was good, “with no change in blood pressure.” Participants did, however, report some side effects (headaches, dizziness, and anxiety).
For people with treatment-resistant depression, ketamine, an anesthetic drug, offers hope. The problem is that it has side effects, such as choking, sedation, and increased blood pressure. It can also be expensive to access. However, researchers at the University of Otago in the United States recently reported that “The safety and tolerability of ketamine may be improved when administered orally, as an extended-release tablet (R-107), compared with other routes of administration.” The American scientists collaborated with other experts from Australia, Singapore, Taiwan, New Zealand and the United Kingdom to conduct a randomized controlled trial testing the effectiveness of ketamine tablets in treating severe depression compared to placebo.
168 depressed patients received extended-release ketamine tablets or placebo
As part of their study, published in the journal Nature Medicinethe team recruited 168 adults for whom standard antidepressant treatment had repeatedly failed. Participants were divided into five groups. Four received different doses of ketamine in the form of extended-release tablets (30, 60, 120 or 180 mg) and one received a placebo twice a week for 12 weeks. Here, “only a tiny amount is released into the bloodstream at a time, with a slow, continuous release over days,” Colleen Looco-author of the research.
During the randomized phase of the trial, most volunteers took their medication at home. “Rather than having to go to the clinic to get an injection and receive two hours of medical follow-up, once or twice a week, it is much more convenient and allows patients to follow their treatment at home,” the researcher said. The data were assessed by the magnitude of the reduction in a patient’s MADRS score. In plain English, this is a measure of depressive symptoms, where the higher the score, the more severe the depression.
Severe depression: Ketamine in extended-release tablet form reduces symptoms
The results showed that patients receiving the highest dose of ketamine (180 mg) performed better than placebo. Specifically, in volunteers receiving 180 mg of ketamine, the mean reduction in MADRS score fell by 14 points from a maximum of 30. In the placebo group, the mean reduction was 8 points. All those receiving 120 mg, 60 mg and 30 mg of ketamine performed slightly better than placebo.
“Tolerability was excellent, with no changes in blood pressure, and few reports of sedation and dissociation. The most common adverse reactions were headache, dizziness, and anxiety. R-107 tablets were effective, safe, and well tolerated in a population of patients with severe depression,” can be read in the conclusions of the work.
