Depression is one of the leading causes of death and crime and now a new treatment has been made, a nasal spray.
This form of treatment is made from a horse tranquilliser and is said to work in as little as two hours, far quicker than widely used medications that can take weeks to kick in.
The liquid contains a compound called esketamine, which is thought to act on the brain chemical glutamate to restore connections between brain cells. It’s used in far smaller doses than the street drug ketamine.
According to the U.S. regulator, the Food and Drug Administration, last week approved the use of the spray for patients with depression that does not respond to other treatments.
Five UK centres are taking part in a long-term trial of the spray, which is used twice a week.
It is the result of changes in brain chemistry, and causes range from genetics and changes in hormone levels, to chronic medical conditions, stress and grief.
A nasal spray has been investigated, as it offers quicker relief because the drug gets to where it is needed in the brain without being processed through the body.
Esketamine works by blocking excess glutamate and this is thought ultimately to repair and restore nerve cells. Animal studies dating back to the Fifties have suggested drugs that act on glutamate may be effective for depression. But it was not until 2000 that the first small study in humans found similar effects.
One new study, reported in the Journal of Psychiatric Research, analysed data on 14 patients given esketamine.
Results showed four of the seven people using the spray responded to treatment after two hours and three went into remission.
None of the seven taking a placebo saw an improvement.
Around 1,150 patients are taking part in a study of the drug at hospitals across the U.S., Canada, South America and Europe. They will use the esketamine nasal spray twice a week; they’ll be monitored for around five years.
Carmine Pariante, a professor of biological psychiatry at King’s College London, said: ‘It is important to stress that only selected patients will use this drug — those with severe depression and who do not respond to currently available antidepressants.
‘Longer studies are needed to fully understand the risks of using this medication. Nevertheless, it is truly exciting that, after many years, we finally have an antidepressant that acts on a completely novel mechanism in the brain.’