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from the improved-outlook-on-improving-outlooks dept.
New studies zero in on roots of depression and why ketamine reverses it
[There's] been significant progress in unravelling the confusion over ketamine, with researchers identifying a ketamine derivative that tackles depression with far fewer side effects. And this week, a team of researchers at China's Zhejiang University announced that they've figured out where in the brain ketamine acts when it blocks depression, a finding that gives us significant insights into the biology of the disorder.
The new studies rely on the work of a number of other labs, which have identified a specific structure deep in the brain that's associated with depression. Called the lateral habenula, it's been associated with a variety of activities, the most relevant of which seems to be the processing of unpleasant outcomes and punishment. Electrodes implanted there have been used to relieve depression in at least one instance.
To test whether this might be the site of ketamine's activity, one team of researchers infused the drug directly into the lateral habenula of rats with depression-like symptoms; it blocked them. So did a separate chemical that inhibits the same proteins that ketamine acts on. Tracking the activity in the area, the researchers were able to show that there are bursts of activity in rats with symptoms of depression that are absent in healthy rats. The drugs that blocked depression suppressed these bursts.
Ketamine blocks bursting in the lateral habenula to rapidly relieve depression (DOI: 10.1038/nature25509) (DX)
Astroglial Kir4.1 in the lateral habenula drives neuronal bursts in depression (DOI: 10.1038/nature25752) (DX)
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(Score: 1, Insightful) by Anonymous Coward on Sunday February 18 2018, @06:39PM
One problem is that these medications don't necessarily impact everybody the same way. Most of the time, the difference is that what works for one person doesn't do much for somebody else, but it can provide the break on depression necessary to do the things that they were too depressed to do. Usually, this is a good thing, but it can also cause somebody to commit suicide or mass murder when they were previously too depressed to do it.
This is one of the reasons why medication is prescribed by trained professionals rather than handed out over the counter.
The bigger issue though is that psychiatric medications are based on unproven science. The belief is that there's a chemical imbalance that causes the illness. But, there's not a whole lot of evidence that the causal relationship is pointed in that direction and popping pills is really just a temporary fix while other treatments that have a much more solid foundation are allowed to work. Therapy tends to work quite well over the long term for most people and the basis for it is relatively well understood when compared with the pills.
To make matters worse, the placebo effect is growing stronger and it's getting increasingly challenging to come up with medications that are effective enough to be approved. The result is that if one of the current medications isn't helping, there's less and less hope that in the future some medication will come along that will work.