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Ketamine Pill Offers Hope and Risks for Treatment-Resistant Depression
Context:
Researchers have discovered that a new tablet designed to slowly release ketamine can alleviate treatment-resistant depression, providing an alternative to the complex and often inconvenient clinic-based treatments currently used for this condition.
Ketamine’s Role in Depression Treatment:
- Mechanism: Blocks glutamate receptors, affecting neurotransmission.
Treatment-resistant depression (TRD):
- It is a form of major depressive disorder (MDD) that occurs when two different first-line antidepressants fail to manage the condition during a depressive episode.
- Traditional Forms: Administered intravenously or via intranasal spray.
- Side Effects: Includes headache, nausea, drowsiness, increased blood pressure, and dissociation.
Extended-Release Ketamine Tablet:
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- Development: R-107, an extended-release tablet, designed to be taken at home.
- Function: Slowly releases ketamine over 10 hours, reducing side effects.
- Clinical Trial: Involved 231 participants with major depressive disorder unresponsive to previous treatments.
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Clinical Trial Results:
- Improved depression symptoms in those taking ketamine compared to placebo.
- Most improvement observed with the 180 mg dose.
- Minimal side effects reported: few cases of severe symptoms unrelated to the treatment.
Advantages of Extended-Release Tablets:
- Convenience: Enables home treatment with fewer clinic visits.
- Accessibility: Particularly beneficial for those in remote or tier-three cities.
- Cost: Approximately Rs. 20 per tablet compared to higher costs of intravenous treatments and nasal sprays.
Concerns and Limitations:
- Enrichment Phase: Exclusion of non-responders could skew results; further studies needed with a broader population.
- Risk of Abuse: Ketamine is a drug of abuse, tablets designed to be difficult to misuse.
- Potential Overdose: Risk of overdose if users with severe symptoms misuse the tablets.