A nose spray that combats depression ‘in minutes’ rather than over months like existing drugs is set to transform the way severe forms of the mental illness are treated.
The medication has been fast-tracked for approval in America after ‘remarkable’ trial results and could be licensed for prescription use in the UK within a year, with experts claiming it may stop people taking their own life.
Patients who previously did not respond to any other medication responded to a single dose of the new drug and the effect lasted for weeks, according to a study.
Depression – persistent low mood that has a debilitating effect on day-to-day life over a long period of time – affects between five to ten per cent of the population.
Treatments include both psychological therapies such as cognitive behavioural therapy (CBT) and antidepressant medication.
The most commonly prescribed drugs are those that target production of serotonin, one of the brain chemicals involved in mood regulation.
The new drug, esketamine, works differently to existing antidepressants in that it targets a brain chemical called glutamate that is involved in the formation of brain synapses, the key connections between brain cells. One theory is that a key cause of depression is a reduction in the number of new brain cells, and by boosting levels of glutamate this can be improved.
The nasal spray is being evaluated by the US Food and Drug administration (FDA) for use in patients with severe forms of depression, including those who remain unwell after several attempts with different antidepressants.
A recent trial of esketamine saw 30 patients with severe or very treatment-resistant depression given one or two intravenous infusions of the drug.
The results, published in the journal Biological Psychiatry, show that effects were seen within two hours and that 67 per cent of the patients responded to treatment, with the benefits remaining after 35 days.
Side effects included minimal dizziness and drowsiness.
The authors compare this response rate to only 37 to 56 per cent of patients after six to 12 weeks with conventional antidepressants. None of the patients given placebo responded.
Other trials have shown patients responding in a matter of minutes to a single dose, reducing thoughts of suicide. ‘It is a very exciting development,’ says Dr Hamish McAllister-Williams, reader in clinical psychopharmacology at Newcastle University and a consultant psychiatrist.
‘Many people do not respond to existing medications and we desperately need new treatments.
‘Depression is a serious condition. It increases mortality rates not just through suicide, but with many physical diseases too. Depression, for example, increases the risk of a heart attack by the same amount as smoking 20 cigarettes a day.’
He added: ‘This drug works in a novel way, and it works in minutes rather than weeks. Such a rapid response is a big surprise.
‘These drugs offer new hope for patients as a treatment that is very different to medications we currently have and also by opening up areas for new research to help us better understand depression.’