Australian study backs affordable ketamine treatment for serious depression

Cheryl Hobbs tried everything to alleviate the serious depression that crept up on her in her 50s, but nothing worked.

Cheryl Hobbs enjoys a moment in the sun on Lammermoor Beach at Yeppoon. Picture: Steve Vit

Cheryl Hobbs tried everything to treat the debilitating depression that crept up on her in her early 50s, going through dozens of different medications and even a few bouts of electroconvulsive therapy over more than eight years.

Having loved her life, travel and adventure, the mother of three no longer wanted to participate in any of it. Her self-doubt became increasingly worse. At a number of points, she says, she was “very suicidal”.

When all regular avenues were exhausted, she enlisted in an early generic ketamine trial. She was in remission for 10 months before the effects of the ketamine wore off.

Now 72, the retired health professional walks along a beach in Yeppoon with her husband, having just road-tripped up from Noosa where she was holidaying with her daughter and grandchildren. The Sydneysiders can see the small island where Ian proposed to Cheryl 44 years ago.

While she isn’t cured, having had to go on more medication after the trial ended, she’s now in a good place.

“I certainly would not have experienced the hope that I experienced,” Cheryl says of the ketamine trial.

“I wanted to go back into sport, be more involved with the kids. I just felt alive. I read a book and really enjoyed reading the book. I wasn’t just checking to see if I retained the information.”

A new Australian study, led by researchers at the University of NSW and the Black Dog Institute, found one in five people with treatment-resistant depression went into total remission after a month of biweekly ketamine injections.

“We’re not talking about everyday community depression, these are people who suffer from the most serious form of treatment-resistant depression,” lead researcher Professor Colleen Loo said. “Often they are so unwell they are unable to work, study, or lead their lives, and are often suicidal.”

Remarkably, she says, a quarter of the 179 patients in the study, published on Friday in the British Journal of Psychiatry, had tried ECT.

Professor Loo explains: “Once depression has not responded to ECT, then depression is at the top end of scale. No one wants to include this group in their studies because it makes your study look bad. They’re hard to treat.”

The large double-blind trial tested generic ketamine that costs just $5 wholesale compared to $800 for the nasal spray currently in use. It means total treatment costs could become much more affordable, with session costs about $350 compared to $1200.

“This is the centrepiece of the evidence base for using generic ketamine in treating depression … It gives us the confidence to use it in the clinic,” Professor Loo says.

Before she saw her GP, Cheryl tried to manage the depression herself. “Put your mask on. Keep going. Be happy,” the voice in her head played on a loop. But eventually it became too exhausting and she couldn’t manage it anymore.

“A lot of friends would say ‘you’re strong, you can beat this’, but I found it didn’t matter how resilient I was or how hard I tried, I didn’t seem to have the resilience to beat it,” she says.

“The effects of the ketamine took a while to build up but it got to the point where I felt really good. It really elevated my spirits and stayed there. I felt positive and back to how I was before.”