Clinician's Digest


Clinician's Digest

By Gary Cooper

January/February 2007


Every few years, a promising new medication for a mental disorder--Prozac and the other SSRIs or the atypical antipsychotics, for instance--comes along. Typically, a few years later, their effectiveness turns out to be less than promised and their side effects worse than anticipated. So it's appropriate to greet the news about a recent study of ketamine hydrochloride that's gotten heavy media play with a healthy degree of skepticism. But this time, the optimism may be justified: in a small clinical trial, a single injection of the drug significantly alleviated treatment-resistant major depression within two hours, and the effects lasted at least a week.

The study of 18 people reported in the August Archives of General Psychiatry found that on the day after infusion of ketamine, 71 percent of the people had significant improvement in their depression and 29 percent actually had remission after receiving this drug. Meanwhile, none of the 14 people who received a placebo injection improved after seven days. Put another way, the effect size of the drug on depression was 1.46 after 24 hours and .68 a week later. By comparison, an effect size of .50 is considered high.

The study, led by psychiatrist Carlos Zarate under the auspices of the Mood and Anxiety Disorders Program of the National Institute of Mental Health, is part of growing research on the role of the amino acid glutamate (methyl-d-aspartate) in the brain. In the past few years, fluctuating…

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2 Comments

Monday, December 3, 2018 9:13:30 AM | posted by JAMES
I have a subscription and a password, but I can't figure out how to access the article. Thanks, Jim

Tuesday, August 29, 2017 11:53:05 AM | posted by Aaron
MDMA is the "club drug" commonly known as ecstasy. Ketamine is a different drug that can sometimes be found in adulterated forms of MDMA (3,4-Methylenedioxymethamphetamine).