For years, patients suffering from depression have been cycled through one drug after the next, a hit-and-miss approach that also reflects the poor odds of success in clinical development. But investigators say a trial of well-known anesthetic called ketamine--often used illicitly in the club scene--has underscored the drug's potential in the fight against depression. And Johnson & Johnson ($JNJ) today highlighted its tweaked version of the drug as one of its top pipeline prospects.
Academic researchers set up a trial with 72 hard-to-treat subjects, with one group getting a low-dose infusion of ketamine while another arm was infused with a different sedative with no known anti-depressive effect. The ketamine arm recorded a 63.8% response rate, compared with 28% in the control arm. After a week, the response rate for ketamine declined to 45.7%, which was still significantly higher than the control arm.
James Murrough, an associate professor of psychiatry at the Icahn School of Medicine at Mount Sinai, said he was drawn to the drug after seeing reports of small studies indicating that ketamine--known as Special K in the party crowd attracted by its short-acting hallucinatory effects--could be a fast-acting depression drug. And there's added urgency in doing some serious study, as it appears a number of people who suffer from depression are already using it to treat their disease.
J&J has a modified intranasal spray version of ketamine in the clinic called esketamine. The pharma giant hired some of the NIH investigators who worked on some of the initial studies of the drug. And J&J neuroscience chief Husseini Manji said the academic studies they've seen on ketamine "have been truly remarkable," putting this program among the pharma giant's top prospects.
AstraZeneca ($AZN), GlaxoSmithKline ($GSK) and others have experienced some bitter clinical setbacks over the years in trying to find effective new anti-depression treatments. GSK swore off the field after R&D chief Moncef Slaoui determined there was really no way to anticipate the placebo effect in studies. And AstraZeneca has cut back its work in the field after a major Phase III failure.
Investigators, meanwhile, have been turning to new studies to see if LSD or other drugs could be repurposed safely for depression.
But as Murrough told the AP, ketamine--also linked to cognitive disorders--is still not ready for prime time, no matter how compelling the preliminary data may be.
- here's the Reuters report on J&J's work
- here's the story from the AP
Correction: This article has been corrected to note that J&J hired some of the NIH researchers involved in the earlier research work on ketamine, not Yale investigators.