Depression is a serious mood disorder with symptoms that include prolonged periods of sadness, hopelessness, and irritability. The symptoms can affect how you feel, think, and handle daily activities. Depression is usually treated with medications, psychotherapy, or a combination.
Chronic stress can lead to symptoms of depression. Studies in animals have shown that chronic stress also leads to the loss of communication between brain cells (neurons) in the prefrontal cortex area of the brain. The neurons lose dendritic spines, the small outgrowths on brain cells that receive signals from neighboring neurons. This leads to altered communication between brain cells.
Earlier this year, the FDA approved a form of the drug ketamine to treat depression. Ketamine is a fast-acting antidepressant that relieves depressive symptoms in hours instead of the weeks or longer that previous drugs required. In addition to being a major advance in treatment, ketamine provides an opportunity for researchers to investigate the short- and long-term biological changes underlying its effects on depression.
Depression is the second most disabling condition globally.1 In older patients antidepressant medications may have lower efficacy.2 Electroconvulsive therapy has greater risks,3 and the efficacy of novel brain stimulation treatments is less certain,4 highlighting the need for new effective and safe antidepressant treatments.
Numerous placebo-controlled studies in adult patients have reported rapid, large reductions in depression scores after a single treatment of ketamine, but none has been undertaken specifically in older depressed patients.5 Current knowledge on ketamine in older depressed patients (aged ≥ 65 years) is limited to five case reports.