>> JOSH GORDON: One of the most exciting recent breakthroughs from research funded by the
National Institute of Mental Health, or NIMH, is the development of a fast-acting medication
for treatment-resistant depression based on ketamine. This treatment is bringing new hope
by making a life-changing impact on people and families affected by major depression.
[music]
>> MJ CROM: My partner actually heard a story on NPR, um, that talked about ketamine treatment
for treatment-resistant depression. I had been in treatment for depression for six or
seven years at that point, and none of the treatments that I had tried had a lasting
impact.
>> CARLOS ZARATE: Ketamine research has given us novel insights into treatment-resistant
depression, the biology of it, and also the biology of suicidal ideation. We were interested
in trying to find drugs that could do some very rapid onset of antidepressant effects,
and ketamine targets a key protein in the brain and then the A receptor, which we believe
would be responsible for rapid onset of antidepressant effects. [music]
>> JOSH GORDON: Ketamine is an anesthetic that increases activity in the dorsal anterior
cingulate cortex, a part of the brain important for regulating emotion and evaluating threats
and rewards. Research shows that ketamine can significantly decrease depression symptoms
after just 24 hours.
>> MJ CROM: So I was an inpatient at NIH for about nine months. The very first infusion
I got, uh, when I got to that point of feeling normal, I suddenly felt energy that I hadn't
felt, literally, in years.
>> CARLOS ZARATE: What's different about our research with ketamine and other types of
drugs is that they have this rapid improvement, very robust improvement, which is much different
than any of the other treatments or types of research we've done before. We have technologies
beyond imagination, from the latest brain image in sleep technologies to magnetic encephalography
that permits us to study the brain in real time.
>> MJ CROM: As a patient who goes to the doctor who has depression, you don't hear about all
of the really cutting-edge things that are-- that are being investigated and that might
really help you. Hearing about all of that really made me feel like there was hope. Just
because I had tried several antidepressants, and none of them had worked, that didn't mean
that I was incurable, that I was never gonna feel better.
>> CARLOS ZARATE: Now that we can see that some of our patients have these remarkable
changes in their life and their view of how they can perceive and function in life, it's
just remarkable.
>> JOSH GORDON: In 2019, the FDA approved S-ketamine, a nasal spray derived from ketamine.
It's the first truly novel antidepressant medication in decades and the first to target
treatment-resistant depression.
>> CARLOS ZARATE: I believe our research has given hope to our patients and their families
because treatment-resistant depression is really an unmet need, where there are very
few treatments. We now have a treatment, can work in hours, which used to take weeks or
longer for severe depression, suicidal ideation. Now that we can improve depression and suicidal
thinking very rapidly, imagine the possibilities for the other mental disorders.
>> MJ CROM: The work that they're doing here is-- they're doing it because they really
wanna help people. If I hadn't decided to join this trial, I wouldn't have discovered
a treatment that really works well for me, and I wouldn't have gotten the, the hope and
the sense of purpose that I got from participating. I think I'm on my way to sort of where I would
prefer to be, as opposed to where depression had put me.
>> JOSH GORDON: NIMH-funded ketamine research didn't just pave the way to an exciting new
treatment. It is also enabling a deeper understanding of the biological causes of depression and
other brain disorders. This knowledge could lead to the development of other therapies
and treatments in the future. [music]