It is a spray with esketamine, a variant of the party drug ketamine. It is a psychedelic drug that is also used by the anesthetist in the operating room and by ambulance personnel as pain relief.
Worldwide, an estimated 300 million people suffer from depression. About 20 to 30 percent of this is not helped with normal treatment. For some of them, a drug like esketamine can prove to be a solution.
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Drug approved
Pharmaceutical company Janssen, part of the American Johnson & Johnson, brought the nasal spray onto the market. A year and a half ago, the American drug watchdog FDA approved the drug. This was followed by the European Medicines Agency EMA.
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The big advantage of esketamine is that it can take effect within a few hours or a few days. With a regular antidepressant this takes four to six weeks.
Little research
But there are also disadvantages. Little research has been done into the long-term effects, for example. “Research into esketamine is complicated anyway, because it is not easy to find a good placebo. This makes it difficult to measure the exact magnitude of the effects,” says Robert Schoevers. He is head of psychiatry at the UMCG and researches esketamine.
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“For about ten years we have been interested in the possible antidepressant effects of the drug. In the beginning, ketamine was administered via an IV and we saw major effects.” But an IV is not practical, patients are then tied to a hospital. “That is why we now give it via a drink, which can be prepared at the pharmacy. We are building up the treatment in the hospital, in order to see how they respond to it together with the patient.”
Severe depression
Not everyone with depression can take this drug. It is only intended for people who suffer from severe depression for years. Patients in whom several different types of antidepressants fail and who have received psychotherapy. “Some of these people have also received electroshock therapy, but that had insufficient effect.”
“These people have a really hard time. I sometimes compare it to cancer, it affects your functioning and your feelings, but also your physical health. For some it is life-threatening. So very drastic. A severe depression is really different from a dip. “
Kayla uses it
In the video below you can see the story of the American Kayla, who already uses esketamine during recurring severe depressive periods.
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Esketamine is only for people who have severe depression. There is still a lot of research to be done and it could also be potentially addictive. Schoevers: “In our program we give it a maximum of twice a week and so far have no indications that people become physiologically dependent.”
Get up
Above all, it helps patients get out of a big dip faster. “You keep the vulnerability to a new depression. But once you get out of your depression, you can work on the things that cause you to become so depressed. I would imagine that esketamine could eventually become worse in a limited group of patients. used as a kind of booster that you can keep ready for when a patient is in a deep trough again. “
Schoevers has published the results of a large study in a number of months in which esketamine was administered per tablet in a low dose and this summer his research group will start a national study in which the drug is compared with electroshock therapy.
“If you can prevent electroshock therapy with esketamine, that is a very big step. But we have to be careful and keep monitoring the people who receive it carefully to see what it actually does for people and what possible disadvantages may be. determine whether you could administer it on a larger scale in the future. “
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