Ketamine for Depression and expectations of therapy

So I came across this article recently in relation to the trial of Ketamine for the treatment of depression Anesthetic for Depression? Mayo Clinic Study Finds Low-Dose Ketamine Effective and being interested in new treatments and appraoches to the treatment of depression, I checked it out. There are a few issues that I have with this release. Number one being the fact that this study is tiny and I don’t mean a small study, but it is minicule, there were 10 participants in it! 8 of which responded to the treatment and only 2 of which were depression free just 4 weeks after the study. Firstly, how does this even warrant a release of news? Surely if only 20% of treatment participants had an ongoing effect, it doesn’t necessarily mean that it was effective, was there a placebo effect or other variable (for instance getting an injection is not a normal treatment for depression, is the social contact with a clinician a variable that needs consideration?). The release does indicate that more research is needed, but why not make a public statement when that research is already on the way, rather than with this sample. A bigger sample will indicate treatment effects better, will allow for blinding and will be a better indicator of population side effects.

Another issue that I have is that the study was not controlled at all, that is that the researchers knew what they were looking for, targeted specific patients for the treatment, gave them the treatment and then tested for the results that they expected. I know that this is just first steps (and as a matter of fact there are other trials of Ketamine currently going on), but my concern is that these first steps should be kept within the scientific community primarily (unless they are searched for) and not disseminated until further trials are conducted. The issue that I see is that the headlines of both the link and the later news articles which came from the link make out that Ketamine is the next cure for depression, that brand new, stout information has been released, but this is not the case at all. 

A quick disclaimer, that I do not disapprove of the use of medication for the treatment of mental illness, however I do disapprove of the poor use of data and statistics that skews the public’s perception of what they should expect from certain medications.

Lastly, I feel that these kind of research studies minimise the importance of ongoing psycho-social care and further medicalise a problem that doesn’t need to be (for the majority of people). By this I mean that Ketamine (or whatever the new wonder drug is) becomes the buzzword in treatment, people expect that to get better from depression the best thing is to take medication, but this is not always the case. Too often I see people who have been prescribed medication and had it not work as effectively as they expected (again the ‘Magic Bullet’ syndrome) and they give up, thinking ‘well, if medication doesn’t work nothing will.’ As a result the therapeutic process is set back and has to commence work on breaking down these expectations rather than working on the presenting issues systematically.

 

 

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One Response to Ketamine for Depression and expectations of therapy

  1. I have found this to be the case in a lot of medications – not just psychological ones. Particularly when heard about on the news, versus actually reading a study – scientific methods aren’t even applied, sample sizes are too small and skewed – but because someone even thought to look at two elements side by side, we need to hear about it.. Unfortunately, we also live in a society where we expect instant gratification, and that includes cures to all our ailments. Easy fix – take a pill.

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