Articles of Distraction

[Angrboda]

A new clinical trial has found that adding repeated intravenous ketamine infusions to standard care for hospitalized patients with serious depression did not provide a significant additional benefit. The study, which compared ketamine to a psychoactive placebo, suggests that previous estimates of the drug’s effectiveness might have been influenced by patient and clinician expectations. These findings were published in the journal JAMA Psychiatry.

Ketamine, originally developed as an anesthetic, has gained attention over the past two decades for its ability to produce rapid antidepressant effects in individuals who have not responded to conventional treatments. Unlike standard antidepressants that can take weeks to work, a single infusion of ketamine can sometimes lift mood within hours. A significant drawback, however, is that these benefits are often short-lived, typically fading within a week.

This has led to the widespread practice of administering a series of infusions to sustain the positive effects. A central challenge in studying ketamine is its distinct psychological effects, such as feelings of dissociation or detachment from reality. When compared to an inactive placebo like a saline solution, it is very easy for participants and researchers to know who received the active drug, potentially creating strong expectancy effects that can inflate the perceived benefits.

To address this, the researchers designed their study to use an “active” placebo, a drug called midazolam, which is a sedative that produces noticeable effects of its own, making it a more rigorous comparison.

“Major problem”: Ketamine fails to outperform placebo for treating severe depression in new clinical trial