High hopes for novel ketamine-psychotherapy trial

University of Otago researchers are recruiting for a novel trial combining ketamine and psychotherapy, in hopes of improving outcomes for those with treatment-resistant depression.

The study is seeking 60 patient recruits from Christchurch and Dunedin for whom regular anti-depressant therapy has repeatedly failed.

Half the participants will receive an eight-week course of the drug ketamine alone; the other group will receive ketamine in conjunction with Behavioural Activation Therapy (BAT).

Study investigator and senior lecturer at the Christchurch department of psychological medicine Dr Ben Beaglehole said while injectable ketamine had a lot of promise as an anti-depressant, the drug’s positive effects were only short-term.

"In our study, participants will be given ketamine as a liquid to swallow, which will work more slowly, be easier to tolerate and lessen the ‘trip’ effect."

The anesthetic drug had been used by doctors since the 1950s for sedation and pain relief, but was classified as an illegal drug for recreational use since the 1980s.

The addition of BAT was the most important aspect of the trial.

"BAT is aimed at activating people with depression, targeting the inactivity which is often part and parcel of the disease, as a means of getting them moving both emotionally and physically to encourage a lift in mood."

The three-year Health Research Council of New Zealand study was seeking volunteers aged 18 to 65 for whom two different types of anti-depressant medication had not worked. Participants would be monitored for a further 12 weeks after the eight week course was finished.

"People will need to be prepared that if they have a positive response, their mood may deteriorate once the ketamine treatment stops," Dr Beaglehole warned.

He hoped the use of BAT would result in people feeling emotionally stronger than before.

"If this trial is effective and can be proven to help delay relapse, it will give genuine hope to people with treatment-resistant depression, and support clinicians more widely in their community use of the drug."