Can Psychedelic Drugs Help Treat Bipolar Disorders?
The party drug ketamine, or “special K” — also a widely used animal anesthetic — may be incredibly useful for treating certain depressed bipolar disorder patients, according to a recent study from the National Institute of Mental Health (NIMH).
The study, conducted on 36 subjects over the course of five years, found that ketamine helps reverse one of the key symptoms that bipolar depressed patients experience: the inability to seek or feel pleasure, medically referred to as anhedonia.
“Imagine if you’re stressed, really, really stressed, and you just don’t want to go out for drinks with your friends. You just don’t feel like it,” Dr. Nial Lally, one of the researchers, told VICE News. “That’s what anhedonia is kind of like.”
Not only does ketamine treat anhedonia, but it does so in about 40 minutes after a single infusion, according to the paper. Other depressive symptoms improved within two hours, and anti-depressive effects from the ketamine lasted as long as two weeks in some patients.
The study focused on individuals with symptoms who have resisted treatment. To measure results, the researchers used positron emission tomography, which measures cognitive function by monitoring activity as a tracer substance makes its way through the brain.
Ketamine’s short onset time is one of the most useful aspects of the study, since the current crop of anti-depressants can take between three and six weeks (and sometimes even longer) to take effect, Lally said. According to Lally, he and the five other scientists who contributed to the study were prompted by the pharmaceutical industry’s lack of research and development in the area of psychiatric drugs.
“I wanted to explore anhedonia, and ketamine has shown to be an effective treatment for depression, so I thought it would be worth testing,”Lally said. “Also, anhedonia is such a widespread symptom that nobody can treat effectively at the moment. Looking into how ketamine might be useful, it might lead to developing other drugs that are less harmful to users.”
Lally is referring to the well-documented side effects of ketamine, that include damage to the bladder, as well as harmful effects on cognitive functions. “It’s not a clean drug,”he said.
The idea in the long run would be to develop a replacement drug for ketamine that would reproduce the effects without the negative consequences. Lally said he hopes to be able to offer long-term treatment for bipolar depressive patients by taking such a drug once a week. Lally and his colleagues have already gotten to work on an expanded version of the study involving 50 or so patients.
Corporate giant Johnson & Johnson, as well as other researchers at the NIMH have been working on using ketamine to treat depression for years, making slow but steady progress toward a cure. Johnson & Johnson already has a nasal spray — using a ketamine imitation — that is undergoing the Food and Drug Administration’s lengthy and expensive approval process.
Originally developed in the 1970s, veterinarians have used ketamine as an anesthetic and on occasion, although rarely, given it to human patients. That’s because the drug can induce psychedelic reactions, such as hallucinations and psychosis. When patients ingest large quantities of the drug they risk triggering these psychedelic effects, commonly referred to as “going down the K-hole.”
The doses that patients in Lally’s study received were far lower than what’s typically used recreationally. For recreational purposes, users often consume doses ranging from 30-300 milligrams, and the drug is usually snorted or ingested orally.
“We don’t have any patients going into the K-hole,”he quipped. “We’re administering 0.5 milligrams of ketamine per kilogram [to the subject]. People don’t do that recreationally.”
Ketamine is one of several psychedelic drugs that in the last two decades that have attracted attention from the scientific community, after years of being ignored by researchers or being forced underground. This shift is likely due to changing cultural attitudes stemming from the perceived failure of America’s “war on drugs,” Brad Burge, the communications director for the non-profit organization Multidisciplinary Association for Psychedelic Studies (MAPS), told VICE News. As a result, much of the research that was shelved or forced underground is now getting a fresh look.
“By the late 1960s, and early 1970s there was a considerable body of research,” Dr. Andrew Feldmár, a Canadian psychologist, told VICE News. “A lot of the research was forgotten, the research that’s resurfacing now isn’t new, it’s making the work that’s already been done, underground and otherwise, legitimate.”
Substances such as MDMA, psilocybin (magic mushrooms), and even LSD — all considered among the most dangerous and addictive substances known to the feds — have undergone successful small studies that have shown promise, particularly in the last 10 years.
“There are concrete benefits that we can see, the evidence is really legitimizing,”Burge said. “The science is starting to catch up. MDMA is poised to be the first proved, prescribable psychedelic.”
According to Burge, MAPS currently has four ongoing studies involving MDMA, and in about eight years and another $12-15 million he expects to have a drug approved for being prescribed to patients.
Despite some success, much of the official research remains in its infancy. Although scientists are beginning to accept that some drugs, such as ketamine, have enormous potential, the relative scarcity of overall research suggests, to some, that there is still some stigma in this area.
“Major foundations, and the government don’t want to conduct research with psychedelic drugs,”Burge said. “There’s a stigma that hinders research funding.”