TeachableMedicalNews article 07262019

Teachable moment in classrooms:

  1. nervous system chapter – synaptic transmission
  2. nervous system chapter – excitatory and inhibitory neurotransmitters
  3. nervous system chapter – regulation of the level of neurotransmitters

Can a street drug be used to clinically treat depression?

The news item:  The Food and Drug Administration (FDA) approval of a new treatment for depression was in the news:

FDA approves ketamine-derived nasal spray to treat depression

The medication is for people who weren’t helped by at least two other anti-depressants.

The new treatment is based on a slightly modified form of the controlled (and sometimes abused) pharmaceutical, ketamine.   The article also mentions the ineffectiveness of current anti-depression drugs, and the new treatment format.

So, Why Do I Care?? Depression comes in several forms, such as persistent type postpartum type, seasonal type, to name a few.  Adding all those together, depression affects up to 17%  of the population, which is tens of millions of people in the US every year.  Depression causes lost work hours, worsening social interactions, even suicides.  Current treatments don’t work for about 30% of those patients. That means that millions of people remain at risk even when treated.

 

Plain English, Please!!! First; let’s talk about depression. This is a disorder of the nervous system.  So, what could possibly make our mood or outlook negative? Those chemicals called neurotransmitters in our brain do that job. Too much of one kind or too little of another kind of neurotransmitters can cause depressed mood.

Second, let’s talk more about neurotransmitters.  These chemicals have a lot of power over our nervous system, and our mood.  Some of these chemicals (serotonin, for example) excite our brain cells, so they elevate our mood.  On the flip side, some of these chemicals (GABA, for example) slow down our brain cells, so they depress our mood.

Third, let’s talk about the new drug.  The controlled pharmaceutical, ketamine, has street names such as Special K, Jet, and Super Acid.  The approved drug is a chemically modified form of ketamine, so it is a close relative of that street drug.  Ketamine fights depression by beating back the neurotransmitters that slow down our brain cells.  Imagine that the GABA neurotransmitter is a bad, spammy snap in your Snapchat snap list.  You can use a snap filter to keep out unwanted snaps.  Ketamine is like a snap filter, because ketamine keeps away from the brain cells the GABA neurotransmitters that would slow them down.  When brain cells don’t get the spammy GABA neurotransmitters, then the activity of the brain cell, and our mood, remains elevated.