Ketamine: An Illegal Drug As A Future Treatment For Depression

Ketamine is a drug known to be used at parties to enhance the disinhibition that already occurs in these contexts. This compound was first synthesized in 1962 as a pain reliever to relieve wounded in combat zones. Also, many vets use it to anesthetize horses.

Since 2006 psychiatrists have begun to discover its powerful antidepressant effect. On the contrary, the problem it presents is its marked and dangerous side effects. If we spend a few minutes exploring the pharmacology of depression, we will realize that  prozac and its generic, fluoxetine, have been replaced by other, more specific types of antidepressants.

A good use and administration of them has managed to enhance their effect, reduce side effects and be more specific for the symptoms to be treated. An example of this are third-generation antidepressants, such as venlaxafin, which work very well for depressions that occur with generalized anxiety. This is how it improves the patient’s disposition to carry out activities, so that the energy it produces finds a way to dissipate in movement.

Even so, 1 in 3 patients with severe depression still do not respond to prescribed treatments and relapses occur in 75% of cases (depending on the type of depression and patient). With this outlook, isn’t it worth considering alternatives?

Depression in today’s world

Although they want to silence it, not even the most famous actors, musicians or programmers of Silicon Valley escape from it. Andrés Iniesta himself spoke of her in his autobiography, as did Bruce Springsteen. Depression will be the main cause of disability in a few years.

The problem is that today, despite the advances, we still do not have multidisciplinary treatments or interventions that are effective for all cases. Hence the need to invest in research and to continue exploring new avenues.

Raising awareness about ecology, mental health and the distribution of knowledge and wealth will set the agenda for the coming years. In addition, it will be good for them to do so if we want to survive as a species and even migrate to other planets.

All these changes influence our mood change, stress crystallizes into sadness and there is a greater proportion of people who feel disconnected from the world throughout this process of change. On the other hand, despite the fact that the context may influence, depression has been talked about since the time of Hippocrates and throughout history it has been attributed different meanings.

Severe depression and post-traumatic stress: people who cannot reconcile with the world

In addition to symptoms related to sleep disturbance, appetite, lethargy, sadness and irritability, t anto in post – traumatic stress and severe depression there is a feeling of loss of control and connection with reality that surrounds people who suffer. All of this leads to a deep sense of hopelessness. Whether due to a trigger or not, depression removes the subject from the world or vice versa.

Selective serotonin inhibitors, such as prozac, together with cognitive-behavioral therapies seem to be the best option to improve the patient’s condition. Specifically, the component of “behavioral activation” is the one that works best.

Medication only seems to improve symptoms in very severe, atypical, or vegetative depressions. Furthermore, pharmacological treatment does not seem to show advantages over psychological treatment in isolation in the medium-long term. It therefore does not seem like a very attractive option and more so if we count the many side effects, although there are times when it does work (without knowing specifically why).

The dissociative effect: the hallmark of ketamine over fluoxetine

As discussed above, the most common antidepressants act as selective serotonin reuptake inhibitors in the presynaptic space, thus increasing their presence in the brain. Something similar to “letting pleasure be for a longer time”, activating the mechanism of “happiness” artificially, stimulating its main neurotransmitter.

However, not all severe depressions improve significantly with this drug treatment. In many cases, this state prevents the initiation of psychological therapy. What then can ketamine suppose in all this?

Ketamine cannot be administered without strict medical supervision. In this sense, different tests are being carried out that are yielding surprising results. The really revolutionary thing would be to isolate the molecule that achieves the positive effects (powerful and fast), thus eliminating the part of the compound that produces the most side effects.

If we compare it with other antidepressants, the speed and the great effect that it produces is what makes the difference in favor of ketamine . On the other hand, this synthesized compound offers hallucinatory experiences and dissociative alterations at the speed of e-mail: the “I” unfolds, suddenly sees an alien reality, perhaps beyond the extreme cognitive dissonance experienced by its “usual self” with respect to to the world.

When the person seems to reconcile with this under the effects of ketamine, we do not know if it is because he is capable of experiencing a parallel reality. In this sense, it seems that the hallucinatory perceptual experience activates the senses of the person in such a way that it amplifies their sensations: so much so that unpleasant memories would not have a place in that “new reality.”

Perhaps it is reality and the stigmas that we create in society that make us sick. Perhaps it is these social products that weaken our emotional defenses and those that produce that tunnel effect in our vision that only allows us to see closed doors. In one way or another, the truth is that depression is increasingly presented as a major challenge : its incidence is increasing and the effectiveness of treatments, therapies and intervention plans need to evolve to be able to give an effective response to all cases . Will ketamine be part of the solution?