Matthew Perry was treated with ketamine for depression - how the former anesthetic can help against it

What is ketamine?
How did the idea of using it for depression come about?
How is depression commonly treated?
How does ketamine work for depression?
What are the benefits of ketamine for depression?
What are the dangers of treating depression with ketamine?
Which patients should not be treated with ketamine?
Can depressed people take ketamine at home to self-medicate?

Medicine - Matthew Perry was treated with ketamine for depression - how the former anesthetic can help against it

It was a shock for fans: the unexpected death of "Friends" actor Matthew Perry. According to the autopsy report, he died from the effects of the anesthetic ketamine. Other causes of death included drowning, heart disease and the effects of a drug used to treat opioid addiction. The death was an accident. According to media reports, Perry was undergoing ketamine infusion therapy for depression and anxiety disorders. He probably received a ketamine infusion a week and a half before his death, but according to forensic medicine this cannot be responsible for his death, as ketamine does not remain in the body for that long.

Depression is also a widespread mental illness in Germany. Over the course of a year, 5.3 million adult Germans suffer from depression, according to the Deutsche Depressionshilfe. For some sufferers, the usual treatment with antidepressants and psychotherapy is not successful. They suffer from so-called treatment-resistant depression - meaning that two or more types of antidepressants have not helped them. It is estimated that up to 30 percent of people with severe depression suffer from treatment-resistant depression. The former anesthetic ketamine can help people with such depression. How ketamine works and how it is used - an overview.

What is ketamine?

Ketamine was developed in 1966 as an anesthetic for veterinary medicine. It was used during the Vietnam War for operations on American soldiers. Ketamine is used in emergency medicine due to its analgesic effect. It also dilates the bronchial tubes and can stabilize the circulation. Because ketamine also has a certain hallucinatory effect, it is also abused as a drug.

How did the idea of using it for depression come about?

When ketamine was first approved as an anesthetic in the USA in the 1970s, patients also reported the mood-lifting effect of anesthesia. Since the early 2000s, intensive research has been conducted into the antidepressant effect of ketamine. In 2014, a study with a small number of participants (20 people) showed that taking ketamine through the nose has a rapid antidepressant effect. Since 2019, ketamine in the form of a nasal spray (esketamine) has been approved in the USA and Europe for the treatment of severe, treatment-resistant depression.

How is depression usually treated?

For a long time, depression was treated exclusively with antidepressants because the cause of depression was thought to be a lack of neurotransmitters, primarily serotonin. Some antidepressants act at this point and increase the concentration of serotonin between the brain cells. This mode of action can help many people. Until depressed people feel a noticeable effect from the medication, they have to take the antidepressants consistently for two or more weeks. Some patients do not last this long due to possible side effects such as weight gain, headaches, dizziness or sexual dysfunction.

How does ketamine work for depression?

Ketamine affects the brain in various ways, and its effects have not yet been researched in detail. We know that the neurotransmitter glutamate plays an important role in mood. One hypothesis about the effect of ketamine is that it blocks the uptake of the neurotransmitter glutamate into the cell. This triggers a series of processes in the brain and reduces negative feelings such as hopelessness and listlessness.

Depression can reduce the number and strength of connections (synapses) in the brain of those affected. In other words, the communication highways in the brain are no longer as well connected or some routes have even disappeared completely. Rachel Katz, Assistant Professor of Psychology at Yale University, explains in a university video on YouTube that ketamine leads to more connections being created in the brain again. This is one reason why ketamine also helps depressed people for whom several antidepressants have had no effect.

What are the benefits of ketamine for depression?

Ketamine offers people with severe depression a new treatment option when conventional antidepressants have failed to help them. One advantage over antidepressants is that ketamine works quickly - sometimes within just a few hours. This means that sufferers do not have to take the medication for weeks to feel an effect. According to a study from 2021, the side effects of ketamine are relatively minor. However, treatment with ketamine does not stand alone. The Charité informs that after successful treatment with ketamine, psychotherapy and/or the administration of antidepressants are still necessary to prevent a relapse into depression.

What are the dangers of treating depression with ketamine?

In the USA as well as in Germany, ketamine is used in the treatment of severe depression. Ketamine is only available on prescription in Germany and is often used in the form of a nasal spray (eskatamine) - its use is strictly regulated. In Europe, ketamine may only be used by doctors and treatment may only be administered under medical supervision. According to a 2021 study, the most common side effects are headaches, nausea, dizziness, headaches and a feeling that the body is disconnected from thoughts. It can also lead to balance problems, an altered sense of taste or psychosis. An increase in blood pressure is also common. In rare cases, panic attacks, mania and out-of-body experiences can also occur.

Ketamine is also abused as a drug. It can be psychologically addictive and prolonged use can damage the central nervous system.

Which patients should not be treated with ketamine?

Anyone who, in addition to treatment-resistant depression, also suffers from poorly controlled high blood pressure, has an overactive thyroid or is in the first trimester of pregnancy should not be treated with ketamine. Patients who have other psychological problems such as personality disorders or addictions should also not undergo ketamine therapy, according to a Charité information sheet.

Can depressed people take ketamine at home for self-medication?

No, doctors in Europe are not allowed to prescribe the drug for self-medication. In the USA, the US Food and Drug Administration (FDA) warned against self-medication with ketamine in October. This is because a problem has arisen in the USA: Numerous ketamine clinics have sprung up that operate in a legal gray area and use ketamine "off label". In other words, they misuse it. Ketamine is also offered on the internet in the form of tablets and nasal sprays for self-medication - although this is illegal in the USA.

Read also:

Matthew Perry's use of ketamine for his anxiety disorder and depression has sparked discussions about its potential as a treatment for mental health conditions. Despite its rapid antidepressant effect, it's crucial to note that ketamine is not a substitute for regular antidepressants and psychotherapy. Misuse of ketamine, especially in the form of self-medication, can lead to psychological addiction and damage to the central nervous system.

Depression is a common ailment, affecting around 5.3 million adult Germans annually. For those who don't respond well to traditional antidepressants and psychotherapy, treatments like ketamine may provide an alternative. However, it's important to note that ketamine should only be used under medical supervision and not for self-medication, due to potential side effects such as headaches, nausea, and alterations in sensory perception.

Source: www.stern.de