Special K

Special K 

"I was suicidal. I was desperate."
"I am able [now] to spend time with my kids, to at least feel like a normal human being. Before, I was one step away from getting into another world. Now those thoughts don't bother me."
"These thoughts [of suicide] don't bother me anymore. I am extremely grateful."
John (last name withheld), patient, Royal Ottawa Hospital

"[Ketamine represents] the biggest breakthrough since the introduction of antidepressants [in the treatment of depression and suicidal thoughts]."
"Our work has shown a direct effect [in a remarkable decrease in suicidal thoughts]."
"Some of our patients have failed many treatments. This gives us the opportunity to not hospitalize them. It has basically changed their lives."
"By acting on the glutamate system, you produce a cascade effect on other systems that can have a beneficial action on the treatment of depression."
"Clinicians must be vigilant [in prescribing ketamine, a known street drug] to the potential for drug-seeking behaviour."
Dr. Pierre Blier, director, mood disorders research unit, Royal Ottawa Hospital

CTV  News photo

Dr. Blier, a professor at the University of Ottawa, wrote a paper, published in the Journal of Psychopharmacology on the use of the drug ketamine on a severely depressed patient. A 37-year-old mother, suicidal and whom other treatments did not help. This is a drug which, in street parlance, is known as 'Special K', not to be confused with a popular breakfast cereal whose name is indeed, Special K. Ketamine, however has been used as date-rape drug. Clinically it had a medical use as an anesthetic.

Dr. Blier's research on the use of the drug has been some six years in the making to finally recognize its efficacy in putting a stop to suicidal thoughts in a high percentage of depressed patients. Given intravenously, John, an Ottawa father of three, is only one of many suicidal patients who have experienced profound relief from their symptoms, enabling them to return to life as close to normal as possible.

The research that Dr. Blier has focused on has been funded by the Ontario Brain Institute and the federal government. What excites Dr. Blier, his colleagues and the patients who have been introduced to the intravenous injection of ketamine is that it works so quickly, in the space of a day. Moreover, 90 percent of patients have been able to report a dramatic decrease in their suicidal ideation. Dr. Blier is researching a potential nasal spray of the drug, with positive results.

For patients whose negative reactions with the use of other drugs has been disappointing, the ketamine breakthrough appears to be a spectacular rescue to patients resistant to other modes of treatment. The treatment of virtual last-resort -- electroconvulsive therapy, with its potential for long-lasting side-effects, is infinitely more invasive, requiring hospitalization in the process.

The dramatic effects of ketamine are not matched by a lengthy after-effect since ketamine can begin losing its effectiveness within a week or less, for some patients. The drug appears safe for most otherwise-healthy patients, but Dr. Blier recommends advanced cardiac life support be available with the use of ketamine as a treatment for severe depression.

It also concerns him that since ketamine is also a street drug, some patients might go out of their way to convince doctors they need this treatment when they actually do not, by pretending to have symptoms consonant with its need. John, remembering his first reaction after ketamine was administered recalls  an "extreme feeling of peacefulness". Although his depression has not been entirely lifted, suicidal thoughts no longer plague him.