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Studying drugs for persistent depression

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By Barbara Ruben
Posted on May 10, 2017

While many people find the fog of depression lifts after taking anti-depressant medications and/or talking with a therapist, some are unable to find relief, even after trying several different drugs. This is called treatment-resistant depression.

Now, researchers at CBH Health in Rockville, Md., are studying two drugs that might work quickly to ease depression.

One drug, called esketamine, is being studied at more than 200 sites around the U.S. and 19 other countries. Esketamine is a form of ketamine, which in addition to being an anesthetic is also more infamous as a date-rape and street drug. But in small doses, it may work to treat severe depression rather than causing hallucinations or sleep.

Works quickly

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In previous studies, ketamine has been shown to have a greater than 70 percent success rate, and it can improve symptoms within hours. In contrast, it often takes weeks for anti-depressant drugs to work, according to Dr. Robert E. Litman, CBH Health’s medical director.

“Some patients are using one or two anti-depressants, but seeing less than 50 percent improvement in their symptoms. So we often find these drugs a little wanting” said Littman. “Esketamine offers a new frontier in terms of a drug to help these people.”

The study is recruiting study volunteers with depression that has not been alleviated by at least one drug. Volunteers must be 18 or older.

During the study, participants will take esketamine (administered through a nasal spray) twice a week, gradually increasing the dose over four weeks. This is not a blind study, so there is no placebo, and all participants will know what they are taking.

There will be a follow-up phase for 24 weeks, during which time some participants may be offered treatment in another study if they are not getting symptom relief.

Another avenue for treatment

The second study looks at the drug rapastinel as an addition to drugs patients are already taking for major depressive disorder. The drug works in the brain similarly to esketamine.

There are three arms to this study: Two groups will take the drug at two different doses via weekly IV injections. The third group will have a placebo injected. Participants will not know which group they are in.

To qualify for the rapastinel study, participants must be between 18 and 65, and currently be experiencing a major depressive episode of at least eight weeks but not more than 18 months. They must have had no more than a partial response to ongoing treatment.

Those in the rapastinel study cannot have a history of schizophrenia, bipolar disorder or posttraumatic stress disorder.

Compensation for time and travel is offered for volunteers in both studies.

For more information, or to see if you qualify, call CBH Health at (301) 251-4702.

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