The study was conducted by researchers at Janssen Research and Development and Janssen Scientific Affairs, Titusville, N.J., and San Diego, and the Yale School of Medicine, New Haven, Conn. Treatment with antidepressants was continued for all the participants throughout the trial.
The medication basically used in anesthesia ability and maintenance, known as ketamine has proved in a clinical experiment that it is in the form of nasal spray helps provide an instant care over the major symptoms of suicidal thoughts and severe depression.
Half the patients also received a nasal spray of esketamine, one of the two molecule components in ketamine, while the others received a placebo.
Ketamine tolerance varied from one person to the next, with half of the group experiencing adverse side effects such as high blood pressure, psychotic-like effects and motor incoordination, which left some participants unable to continue to self-administer the spray. The esketamine effects were not greater than the placebo at 25 days.
The effects had levelled out after 25 days, however. Clinician global judgment of suicide risk scores were not notably different between treatment groups at any time point.
The results of the study support nasal spray esketamine as a possible effective rapid treatment for depressive symptoms in patients assessed to be at imminent risk for suicide, according to the authors. The most common events among those receiving esketamine were nausea, dizziness, dissociation, unpleasant taste and headache.
The rapidity of the ketamine treatment is of particular interest as most antidepressants take more than a month to become fully effective. In this double-blind, proof-of-concept study, researchers examined the efficacy and safety of intranasal esketamine vs. placebo for the rapid reduction of depressive symptoms and suicidality in patients with major depression. "Such steps initiated early in the development of ketamine and other drugs whose therapeutic potential is complicated by the potential for abuse would not be meant to deny therapeutic help to patients with significant need", Freedman and colleagues wrote. That caution is also the focus of an accompanying AJP editorial also published online today. "We look forward to the completion of our ongoing phase 3 trials and to bringing this important, potential new therapy to patients in desperate need". The Editors suggest the need for broad input in the development of effective controls on the distribution and use of ketamine.
Dr Robert Freedman, editor at American Journal of Psychiatry said in a statement that, "Protection of the public's health is part of our responsibility as well, and, as physicians, we are responsible for preventing new drug epidemics".
Ketamine could be used to treat people at imminent risk of suicide.
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