Depression kills at least 100,000 Americans a year (20% of those from suicide).
These deaths are preventable, just like using seat belts has saved so many lives. These people die because the medical community is not providing the best possible care to save them. There is no conspiracy, “simply” the inability of our medical system to use a medication whose patent has expired. Drug companies cannot afford to sell it for this use. Doctors won't take a risk without drug company backing. But if there were enough pressure, then action would be forthcoming.
Over 100,000 Americans die from Depression each year. You can do the math from these three studies:
This study
And this study
And this study.
Mental illness is not something people like to talk about – especially when it is you or a family member who is ill. A lot of people don’t even think depression is a mental illness, and some believe it is nothing more than a case of the blues. The stigma around depression comes from the (correct for now) perception that it is a life and behavior altering disease that people wrestle with for much of their lives.
Depression is different things to different people because it is not a single illness – it is in some cases an illness, sometimes a symptom of another illness, sometimes a co-existing disorder caused by another mental illness. This complexity masks the fact that about 1/3 of people get better with current treatments like therapy. The other 2/3 have what is quaintly called "treatment-resistant depression." These non-medication solutions should always be tried before any medication is considered unless the person is suicidal.
Scientific understanding of depression is in its infancy. Theories of low neurotransmitter levels “causing” depression have been debunked both by showing that anti-depressants that moderate the level of neurotransmitters work no better than sugar pills and by neuroscientists’ discovery that the physical structure of the brain is damaged in depression.
Then came Ketamine. Ketamine is an anesthetic that has been around since the early 1970’s and used extensively, and safely, around the world ever since (Yes, at high dosages it is known as the party drug “Special K”, but the doses used for depression are many times smaller than the party dosages and the amount used as an anesthetic.)
There are probably close to 1,000 people who have been involved in one of the dozens of trials of Ketamine. The amazing thing about Ketamine is how fast it works for most people – they experience relief in hours. Scientists scoffed at the results until they did brain imaging studies and discovered that Ketamine treatment re-grew neurons in an hour. The video link is to one patient’s first treatment and a close look at what happens in the brain:
Video of One Person's Before-And-Afer Experience
Ketamine is even being tested in emergency rooms to treat suicidal patients as seen here. Imagine a one-hour visit instead of a 72-hour psych ward hold. A saved life and saved money at the same time.
Where to from here? Without government intervention, the picture is not good for the average person with depression. Used as an “off-label” medication with no support from drug companies, the treatment ranges from $500 to $1,000 per treatment (and insurance does not cover it), and there are only a handful of clinics if you are not lucky enough to be included in a trial. The top 10% will be able to afford treatment, others not so much.
Alternatively, you can wait and hope that Big Pharma “successfully” reverse engineers ketamine so it can patent a new medication. Of course, that new medication would cost an amazingly higher amount than the $3 per dose today (the treatment costs so much today because of the liability of no FDA approval and the high marketing costs spread over a few number of people).
Drug companies are fighting to suppress ketamine use by pointing out its side effects,because at high dosages it can cause hallucinations. And too much water will kill you if we're going to use that test. Drug companies are using an apple-to-oranges comparison of their experimental drugs at low dosages versus ketamine at high dosages to scare doctors away from trying ketamine and to wait for their products. But there have been no reported significant side effects when ketamine is used for depression. None.
At least three drug companies have Ketamine replacements in the pipeline. In no case do these new medications work as well as Ketamine. In one particularly egregious example, Johnson and Johnson is attempting to claim that the active ingredient in ketamine sold today (S-ketamine, a chemically identical form as the other form in ketamine) is actually a new medication.
But I for one don’t think we should let years pass as we watch 90,000 untreated Americans and an untold number of people across the world succumb to a disease that is treatable if we were only to change the economic system that protects the status quo. It wouldn’t even cost a dollar – it would save money – depression costs our economy an estimated $80 billion per year and is the leading cause of adult disability.
We can do much, much better:
1. Email the FDA using this web link and ask why ketamine is not being considered for approval for depression. Point out there is a history (with Lithium) of the FDA doing the needed studies themselves if the medication has no patent.
2. Email the US Health and Human Services Department using this web link or call at 877-696-6775.
3. Talk to your own doctors about ketamine and don't let them use the standard drug company propaganda.
4. Call your insurance company and ask why they don't pay for ketamine treatment when they pay so much for depression-related hospitalizations and other drugs.
5. Ask your friends to do the same.
WE can make a difference.
Full Disclosure: I've started a ketamine clinic. I think you would do the same if that were the only way you could help your own children. Put me out of business by making the treatment widely available and I will be very satisfied.