- For one thing, there’s no side effects to taking pills everyday. There’s also no internalized stigma from taking psychiatric medication everyday.
- Secondly, it works rapidly. It works in hours, not weeks.
- Lastly, the treatment becomes patient-oriented. Pills are disease-oriented, not patient-oriented. With pills, you get the same effect everyday. With an infusion, you get a much stronger effect, and an effect that wanes slowly over time.
Psychiatry may be on the verge of a new era.
Everyone knows that SSRI antidepressants, drugs like Prozac and Lexapro, have been around a long time. Their efficacy is overblown. Studies show they are no more than 40-50% effective. They’re good medicines in many ways, but many people aren’t content with the sexual side effects, or the weight gain. And at high doses, people feel numb. And there’s that pesky black box warning: for the first two weeks, you may actually get WORSE before you get better.
So, if they are not ideal… what’s going to replace them?
Many experts believe, intravenous medication. Instead of taking pills everyday, that in the near future, we may be treating depression rapidly with intravenous medication. We are already doing it with KETAMINE, a commonly used anesthetic compound, that, at a low dose, works amazingly as a rapid-acting antidepressant. Studies are showing that ketamine is around 80% effective at treating depression. That’s about twice the effectiveness of Prozac.
But… have you heard of RAPASTINEL? Few people, even among doctors, know about it. It is a new medication is coming out in a few years. It has been called a ‘breakthrough therapy’ by the FDA. It acts in a similar way to ketamine. It is still undergoing trials with the FDA, but studies are showing it to be very effective, like ketamine. And it works rapidly.
Like ketamine, it will be given as an intravenous infusion.
There are several advantages to the idea of treating depression with an infusion:
What does this mean for the patient? It means that the patient is participating more in his or her care. For example, a few ketamine infusions may raise the mood for a few months. During that time, since they aren’t taking a pill daily, patients are more sensitive and able to notice the factors which cause them to drift back slowly into depression. With antidepressants, this isn’t normally the case.
This is the same reason many psychotherapists in the 1960s actually opposed their patients taking medications everyday. Hardly anybody recommends this nowadays, and yet, the idea was well intentioned, and important.
With rapid acting infusions, we are getting back to the older wisdom.
– Thomas Cook, M.D.