A nasal spray version of the drug ketamine has shown promise as an antidepressant, even if its properties still aren’t well understood. The approval of esketamine marks a new approach to treating serious mood problems, experts said. Prozac and similar drugs enhance the activity of brain messengers such as serotonin; they are mildly effective, but they take weeks or months for their effects to be felt, and for many patients they provide little or no relief from depression. In contrast, the ketamine-based compounds — several others are being developed — work within hours or days, and are effective in some people who are considered “treatment resistant,” meaning they have not benefited from other antidepressants.
“What seems remarkable is that the drug also seems to help domains other than depression, like anxiety, suicidal thinking, and anhedonia” — the inability to feel pleasure — said Dr. Zarate, chief of the N.I.M.H.’s experimental therapeutics and pathophysiology branch. “It seems to have more broad effects, on many areas of mood.”
https://www.nytimes.com/2019/03/05/health/depression-treatment-ketamine-fda.html
A colored positron emission tomography scan of the brain of a depressed person, highlighting regions (in red) where blood flow and metabolic activity are unusually low. Credit WDCN / Univ. College London, via Science Source.
