According to a recent CNN article, there is an alternative for those with severe treatment-resistant depression. "Ketamine is a powerful medication used in hospitals primarily as an anesthetic, but new scientific studies have shown significant promise with treatment-resistant depression and suicidal ideation."
As a side note, Ketamine is also used recreationally, and illegally, as a club drug known as "Special K." It generates an intense high and dissociative effects.
Dr. Kevin Kane is a practicing anesthesiologist and medical director of the Ketamine Milwaukee clinic. Operating once a week, Ketamine Milwaukee is in a space subleased from a weight-loss clinic in a nondescript strip mall right outside the city. Because there haven't been any new classes of drugs developed to treat depression in decades, Kane said that using ketamine to successfully treat the disorder's most stubborn cases might just be "the biggest breakthrough in mental health in the last 50 years." Up to 70% of patients with treatment-resistant depression experience relief with ketamine.
Ketamine is administered intravenously and patients experience quick relief—often within hours. Treatment is expensive; ketamine infusions cost $495 each at Ketamine Milwaukee. Kane recommends "an initial series of five to six infusions, after which patients generally return every four to six weeks for booster infusions."
Ketamine works in depressed patients by growing synapses in areas of the brain that have atrophied, primarily the hippocampus and prefrontal cortex. "If you think of it like a tree that loses its leaves in wintertime, ketamine helps grow those leaves back," Kane said. "It doesn't necessarily have to grow an entire new branch or an entire new tree. It just has to sprout new leaves."
Interestingly enough, ketamine's dissociative properties that appeal to party drug users are what make it so effective in treating major depression.
"Sometimes, that can be a very powerful thing, that dissociation," Kane said. "While you're dissociating from your body, you may be dissociating [from] your mind as well. And, you may be able to see your problems and your issues that have really been consuming you as, 'Yes, they're still here, but now they're over there. They're in a little ball in the corner, and they don't have the power over me anymore.'
"(People) can have very profound thoughts along those lines and realizations that they can take back to their therapy session, and (it) can be a really wonderful stepping stone for them to help maintain their relief."
Treating depression with ketamine is considered an "off-label" use of the drug, therefore it is not covered by health insurance—even if recommended by a doctor. The results from patients are priceless though, so it's worth pursuing if persistent depression is an issue.