Ideal antidepressant medication should act quickly, cause
fewer side effects and should treat almost all depressive patients with similar
efficacy. But current antidepressants are far cry from above ideals.
Sources
http://www.smw.ch/docs/pdf200x/2007/15/smw-11932.PDF
Antidepressants medications are the most common way to treat
depression. Unfortunately around 60% of patients are considered to have
resistant depression and antidepressants have delayed action. These patients
suffer from depressive symptoms even with medications. One of the reasons for
this situation is that scientists and doctors do not exactly know the mechanism
of depression in the human brain.
Most of the antidepressants currently in use are developed
from molecules identified purely due to chance. For an example imipramine (Tofranil)
is the first antidepressant developed. It was identified as having anti-depressant
properties purely due to chance and brilliant observation of Roland Kuhn. Imipramine
was first tried in patients with schizophrenia. But there was no effect on most
of the patients. But a subgroup of patients who had depressive symptoms
improved with this medication. It was noted by Kuhn and further studies were
performed.
In fact, almost all the antidepressants currently in use
have similar efficacy to imipramine. Newer antidepressants have improved
tolerability and reduced side effects profile, but without any improved
efficacy.
In addition, all the antidepressants have to be taken more
than one week to get the antidepressant effect. This is one of the major drawbacks
in current antidepressant medications.
Newer rapid acting
antidepressant medication
Ketamine is a widely used anesthetic medication. In
addition, it is a drug of abuse and in streets it is known as Special K. It was
known to cause hallucinations and various psychiatric manifestations. In
addition, Ketamine is a powerful Glutamate agonist in the brain.
Now growing clinical trial data suggest Ketamin has quick antidepressant
effect. In fact it treats depression within 72 hours. In addition, it seems to be effective against
resistant depression that is not responding to medications and ECT (Electro
convulsive therapy). But Ketamine is used only in expert centers.
This effect of Ketamine opens a new door to the identifying
true mechanism behind depression. When it is identified, newer antidepressants
can be developed with very quick action, efficacy and fewer side effects
profile.
http://www.smw.ch/docs/pdf200x/2007/15/smw-11932.PDF