Ketamine has shown promise in treating treatment-resistant depression, but the current form of the medication requires clinical supervision, making it expensive. A recent early-stage study tested an experimental slow-release ketamine capsule that can be taken at home, which could potentially reduce costs if it makes it to market. The current form of ketamine treatment involves a nasal spray or injection, which requires patients to stay in the clinic for monitoring for around 2 hours. The FDA currently only approves ketamine for short-term sedation and anesthesia.
Injected ketamine has been shown to be more effective than the nasal version, esketamine, and larger doses are most effective. Ketamine starts working within hours, unlike traditional antidepressants that may take weeks to show results. Ketamine can provide rapid relief for individuals with severe depression, which can be life-saving. However, ketamine also has potential side effects and abuse potential, making the development of a safer form of the drug crucial.
The recent BEDROC study tested an experimental slow-release ketamine capsule designed by Douglas Pharmaceuticals in New Zealand, called R-107, which slowly releases ketamine over 24 hours. Participants with treatment-resistant depression were split into groups receiving varying doses of R-107 or a placebo. The study found improvements in depression symptoms in the groups taking R-107 compared to the placebo group. The treatment was well-tolerated, with common side effects such as dizziness, headache, and nausea reported by participants.
Ketamine acts as an NMDA receptor antagonist in the brain, leading to a cascade of neurochemical events that promote synaptic plasticity and alleviate depressive symptoms. The drug may also affect the brain’s default mode network and reduce inflammation, further reducing symptoms. While the results of the recent study are promising, further research is needed to replicate the findings in larger, longer trials globally. Douglas Pharmaceuticals plans to conduct Phase 3 studies to determine the effectiveness of R-107 before it can become widely available as a treatment for treatment-resistant depression.
In conclusion, the development of a slow-release oral version of ketamine could potentially reduce costs and make the treatment more accessible for individuals with treatment-resistant depression. The recent study showed promising results in improving depression symptoms with minimal side effects compared to traditional forms of ketamine. Further research and larger trials are necessary before the drug can be widely available, but the potential benefits of a safer and more cost-effective form of ketamine for depression treatment are significant.