Ketamine: club drug, 'horse-tranquillizer', and... miracle antidepressant? I've blogged about the research behind the claim that ketamine has rapid-acting antidepressant effects severaltimes. Since 2009, my view has been that it is impossible to tell whether ketamine has specific antidepressant properties, because ketamine has never been compared against an 'active placebo' control. In trials, patients given ketamine report feeling better than patients given no drug. But these trials weren't really double-blind, because ketamine is psychoactive: it causes hallucinations and other subjective effects. Patients feeling these effects will have known that they had got the real drug, not the inactive control, potentially leading to a greater placebo effect. I've also speculated that experiencing the consciousness-altering effects of a psychoactive drug could help depressed people through psychological mechanisms - for example, by giving patients hope that it is possible for them to feel better. Now, in October last year, James Murrough and colleagues of New York revealed the first published data comparing ketamine to an 'active control'. They reported that ketamine was more effective. I didn't blog about it at the time, but this week a very interesting paper appeared in
Drug and Alcohol Dependence from Dakwar et al