A New Drug for Serious Depression: The Good News and the Bad
A just-released study from McLean Hospital finds that esketamine works, but ...
Posted July 16, 2020 | Reviewed by Ekua Hagan
In a study of depression treatment released just last week by researchers from McLean Hospital, a renowned psychiatric hospital in Belmont, Mass., authors Ross and Soeteman report that esketamine, a medication for the treatment of severe depression, generally does work, and more effectively than standard anti-depression drug treatments. Though not for everyone or 100% effective, it does tend to alleviate a depression's intense dark cloud. The drug even has already been approved by the U.S. Food and Drug Administration (FDA) for use in treatment-resistant major depressive disorder. That's the good news.
The bad news: So far at least, the medication is currently too expensive for widespread use.
While it is similar to ketamine which is delivered intravenously to treat severe depression, esketamine differs in its mode of administration. It is a nasal spray. Sounds good so far! Unfortunately though, at $240 per spray, the cost would be prohibitive for most depression sufferers.
When you look at this cost over time, the price tag looks even more, shall we say, depressing. The drug needs to be administered as an on-going medication. For the initial month of the nasal spray treatment, the cost would be approximately $5,572. Subsequent costs would range from $1,699 to $2,244 every month.
Ross and Soeteman's study compared the benefits and costs of the nasal spray version of ketamine with the costs and benefits of the currently broadly used antidepressant medications. They found that with regard to benefits, while not perfect, esketamine increased time in remission from 25.3% to 31.1% over conventional drugs. They concluded, however, that the financial outlay would need to be reduced from the current $240 per dose to $140 per dose to be cost-effective in terms of health care and general societal expenses.
Ross and Soeteman's research report concludes with a plea. Will policymakers, insurers, and health care leaders work to reduce the price of esketamine and make it more available to those in need?
The videos below illustrate two new interventions that I have found to be especially effective for alleviating depression.
Though the depression-relief techniques in the videos below both are relatively new to the field, I have been using them in my clinical practice for several decades, I have not had access to a research facility that could conduct systematic scientific research on them. Prior to my recent retirement however, the interventions have been yielding quite consistently positive results for my clients.
Do bear in mind that my experience as a clinical psychologist has been in treating individuals with mild to moderate depression, not severe depressive disorders. Still, I have found that these non-drug interventions, which clearly help individuals with reactive depression, sometimes also offer relief for individuals who suffer major depressive episodes.
The first video explains a technique that can be used as a self-help treatment. At the same time, the participation of a therapist who is open to learning the intervention may add to its efficacy.
I explain the technique and why it works in more full detail in my book and free website, Prescriptions Without Pills.
If you have been depressed, at whatever level of intensity, it can be a good idea to try the above visualization technique. The treatment is free and without downside side effects.
This next video demonstrates a technique that requires the help of an energy healer who is experienced in the use of muscle testing. Such healers, who also refer to themselves as energy therapists, can be found via an internet search. Practitioners of the energy healing technique called Emotion Code in particular utilize muscle testing as a core part of their work. So do many healers who use acupoint tapping, also called Emotional Freedom Technique.
Energy techniques work on your body's electrical system as opposed to its chemical system. Dale Petterson, who illustrates the technique in the video below, utilizes an interesting finding that neuroscientists discovered from the use of MMRIs. When someone is depressed, the MMRI shows more energy in the right than the left pre-frontal lobe. When someone is happy, the left pre-frontal lobe has more energy.
One word of caution to keep in mind with all severe-depression treatment methods
The most dangerous, and potentially even lethal, time for people who suffer from depression is the days/weeks in which they are emerging from a depressive episode. If you were to graph the fall and then eventual rise of energies in a depressive episode, the curve—with a long time on the bottom of the "u'" and then eventually back upward—note that on the uphill side positive energies rise in a smooth line. As energies return, their upward rise generally includes abrupt ups and downs—jagged peaks followed by sudden cliff-like drops. Fortunately, the sudden lows generally give way to rapid returns to ever-higher positive energy levels.
Suicide danger can become serious during these abrupt shifts, that is, if a formerly depressed person who has begun feeling better encounters a difficult life event (job loss, relationship threat, etc). The intensity of the difference, that is, the gradient of change between the higher energy level and a sudden drop in positive feelings, can feel devastating. Be forewarned.
And be prepared. Before trying these treatments, write out and sign a clear agreement, a contract with a therapist or loved one, to 1) contact them if suicidal thoughts arise, and 2) that you will not allow suicidal actions to be an option. A pre-signed contract can enable an individual to over-ride the re-emergence of suicidal thoughts so that they can enjoy again the benefits of life in the realm of well-being.
In sum, if you have been seriously depressed ...
New treatments for depression are emerging. Whether they are chemical, based on acupuncture, new forms of talk therapy, or new energy treatment interventions, If you do suffer depression, keep scanning for new developments. Even if your depressed mind keeps telling you that nothing is going to help, open yourself to trying new options. Eventually, one of these will work for you.
Ross and Soeteman. (2020). Cost-Effectiveness of Esketamine Nasal Spray for Patients With Treatment-Resistant Depression in the United States. Psychiatric Services. DOI: https://doi.org/10.1176/appi.ps.201900625