Could an injectable drug unlock the darkness of depression?

Infusions of ketamine being used off label

CORAL GABLES, Fla. – Major depression is one of the most common mental disorders in the United States.

For those who don't respond to antidepressants and other, more drastic therapies, there is a promising, yet controversial drug therapy.

"We've been using it successfully in patients for quite some time with very positive results," Dr. Raul Cruz, with Ketamine Health Centers in Coral Gables, said.

Dr. Marc Ettensohn of Actify Neurotherapies in West Palm Beach also provides infusions of ketamine to people with severe depression. 

"This has been around since the 1960's as a safe and effective anesthesia medication," Ettensohn said.

Brian Ehlers and Nicole Winkler both turned to ketamine infusions after suffering from depression for decades.

"It sucks all the good things away from you," Ehlers saidof the condition. "It takes away tomorrow and without tomorrow, life isn't really worth living is it?"

Winkler echoed his sentiments.

"With depression, everything is dim. Things you love hold no value anymore and you physically manifest the stress you feel," she said.

Ehlers and Winkler are among the 30 percent of Americans who do not respond to conventional treatment therapies for depression.

"I went down the road of traditional methods of treatment and I had a horrible experience," she said.

"It gets to the point inside of you where you know there's just nowhere to go," Ehlers said.

Ehlers was on the verge of getting electroshock therapy when he learned about ketamine, what some know best as a psychedelic club drug called "Special K."

"Some drugs can be abused that are medically useful and there's nothing we can do about that," Cruz said.

Brian Ehlers considered electroshock therapy before he used ketamine to treat his depression.
Brian Ehlers considered electroshock therapy before he used ketamine to treat his depression.

For its use in the treatment of depression, Ettensohn said there isn't a euphoric effect.

"We are using extremely low doses, sub-anesthetic doses," Ettensohn said. 

Even so, Ehlers relates to experiencing a slight "ketamine high."

"But that passes after 30 to 40 minutes and you feel completely normal," he said.

Memorial Healthcare toxicologist Alberto Augsten said in the wrong patient, ketamine could cause serious side effects.

"For instance, someone that's predisposed to psychosis or schizophrenia, ketamine will make them even more psychotic," Augsten said.

Since ketamine is not approved for the treatment of depression, patients must pay out of pocket, sometimes thousands of dollars, for the treatments and the benefits are not permanent.

"Some patients will come back as frequent as once every month, others will come back less than once a year," Ettensohn said.

"We don't want people to keep coming back forever but if they need to come back for a year, that's totally fine," Cruz said.

Nicole Winkler says ketamine injections have eased her depression symptoms.
Nicole Winkler says ketamine injections have eased her depression symptoms.

While the long-term effects of the drug are unknown, Ehlers and Winkler credit ketamine injections with finally lifting them out of the darkness of depression.

"I felt it was worth the risk and I'm glad I did it because it changed everything from day one of the treatment," Winkler said.

"I was without any further recourse, I wouldn't be here, I would have committed suicide," Ehlers said.

Two major pharmaceutical companies are now fast-tracking new medicines inspired by ketamine.

A nasal spray version of the drug could be on the market by this time next year.

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