Ketamine Nasal Spray May Help Reduce Depression Symptoms, Study Says

By Kelly Burch 04/20/18

A new study found that the spray began to relieve some depression symptoms in as little as four hours.

hand holding a nasal spray

The nasal spray Narcan has saved thousands of lives by rapidly reversing the effects of an opioid overdose. Now, a similar life-saving option could be on the horizon for people with depression, after a study found that a ketamine nasal spray can rapidly reduce suicidal ideation in as little as four hours. 

The study, published in The American Journal of Psychiatry, examined 68 people with depression and suicidal ideations. Participants were randomly assigned to get either a placebo or a nasal spray containing esketamine, one of the components of the hallucinogenic drug ketamine, twice a week for four weeks.

The people who received esketamine reported that their depression symptoms rapidly reduced compared with the placebo group, beginning just four to 24 hours after the first dose was administered.

However, by the end of the month the placebo group had similar outcomes. Both groups were on "standard antidepressants" during the study.

“These preliminary findings indicate that intranasal esketamine compared with placebo, given in addition to comprehensive standard-of-care treatment, may result in significantly rapid improvement in depressive symptoms, including some measures of suicidal ideation, among depressed patients at imminent risk for suicide,” study authors concluded. 

The nasal spray could potentially be instrumental in treating people who are at risk of suicide. Most antidepressants take weeks to be fully effective, during which the person is still at risk of suicide. 

James Stone, a Clinical Senior Lecturer from the Institute of Psychiatry, Psychology and Neuroscience at King's College London, told Newsweek that there is "a lot of potential for the use of ketamine as a second or third line antidepressant where other treatments have failed.”

However, he acknowledged that the study is small and scientists are still just beginning to understand how ketamine can be safely used to treat depression

"Although ketamine is potentially a huge breakthrough in the treatment of depression, we still don’t know about the long-term safety, or about how to keep people well from depression without requiring regular ketamine dosing," he said. "Further studies are needed to address these questions.”

Stone also pointed out that any treatment with ketamine would need to be carefully controlled so that patients do not abuse the drug. 

"The formulation of ketamine as an intranasal device simplifies administration greatly, although if it was used clinically it would be very unlikely that patients would take the device home—they would more likely be required to come to a day hospital type setting—because of risks from both the acute effects of the drug, and also risk of addiction or diversion of the ketamine," he said.

In an editorial accompanying the study, editors of The American Journal of Psychiatry expressed similar concerns. 

"Protection of the public's health is part of our responsibility as well, and as physicians, we are responsible for preventing new drug epidemics,” they wrote. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.