Recreational drug Special K at focus of new treatments for depression

Ketamine, a common anesthetic, has entered the mainstream as a potentially game-changing treatment for depression.

Published on May 31, 2023 Last updated 25 minutes ago 3 minute read

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Dr Jennifer Phillips is Acting Chief Science Officer at the Royals Institute of Mental Health Research. Photo by Tony Calwell /Postmedia

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Ketamine, a common anesthetic drug that has another life in a psychedelic club drug called Special K, has entered the mainstream as an innovative and potentially game-changing treatment for depression.

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It will be the focus of a new clinic at The Royal in Ottawa.

Esketamine, a form of the drug given in a nasal spray, and ketamine are key treatments offered at the new BMO Innovative Clinic for Depression at the Royals Institute of Mental Health Research.

The clinic, aimed at helping people with hard-to-treat depression, is supported by a $2 million donation from the BMO – the largest corporate gift in Royals history.

The clinic will give hope to those whose depression has not responded to other treatments, said Dr Jennifer Phillips, acting scientific director at the Royals Institute of Mental Health Research. Patients who meet the requirements will be referred to the clinic via specialists at The Royal or The Ottawa Hospital.

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The treatments will be integrated with research into further innovative treatments in the coming years, Phillips said.

About 30 percent (of patients) find their symptoms don\’t respond to conventional antidepressant medications, he said.

For those patients, for whom depression can be life-altering and even life-threatening, ketamine is now seen as an important option.

Esketamine, the nasal spray approved for use by Health Canada, elicits a higher response in patients than conventional antidepressant treatments, Phillips said.

Phillips calls it a game changer, in part because of its ability to relieve depression in many people who have not previously responded to treatments and also because of how quickly it works.

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If it works well, we can see a dramatic transformation, he said. (Patients) may have lost all hope; they might think about suicide. After treatment, those thoughts go away.

The drug is seen as a major breakthrough in how depression is treated at a time when the demand for treatment of mental illnesses, including depression, is on the rise.

Conventional antidepressants work by changing the level of serotonin and norepinephrine in a person\’s brain. Both are related to mood and feelings of well-being.

Ketamine acts on the neurotransmitter glutamate, which plays a key role in cell signaling in the brain.

Phillips says researchers are still studying exactly how this works, but it increases neuroplasticity by allowing the brain to form new pathways or connections. Ketamine and eskatamine appear to act significantly faster and more extensively than conventional antidepressants.

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The discovery of ketamine\’s antidepressant effects represented a paradigm shift. They\’re definitely very exciting because they work differently, Phillips said.

The new Royals clinic comes as a growing number of private clinics across Canada offer ketamine therapy for depression and other mental illnesses.

Some already exist in Ottawa. The latest, operated by the Canadian Center for Psychedelic Healing (CCFPH), will open on Sparks Street in late June.

It will be the first in the city to offer ketamine-assisted psychotherapy, says Dr. Neel Chadha, medical director of CCFPH and an Ottawa family physician.

The clinic offers ketamine, administered orally, along with psychotherapy for the treatment of depression, anxiety, PTSD, trauma, addiction, substance use disorder, and eating disorders.

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The two-hour sessions, in which therapy begins once patients reach a dissociative state, cost around $715. An evaluation is covered under OHIP, but treatment is not, although some private health insurance plans do cover it.

The company says that more than 93% of patients showed improvements in anxiety and depression scores after undergoing the treatment.

The company describes KAP as a holistic therapy that can allow a person to open a new perspective on their mental health, emotions and relationships, providing an opportunity for lasting change.

It also operates clinics in Thunder Bay and Sault Ste. Maria. More information is available at ccfph.com

With the rise of private ketamine clinics, some researchers in the United States have warned that not enough is known about the drug\’s use to treat depression and other mental health disorders and its use should be limited to clinical trials and trials. academic environments where it can be studied further.

That\’s one of the goals of The Royals new clinic, Phillips said.

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