People have suffered from depression forever. In the 5th century BC it was called melancholia. Treatment was offered through lifestyle changes, i.e., diet, exercise, sleep, massage, bathing, bloodletting, and vomiting. In the Middle Ages it was believed to be a disease of the spirit – demonic possession – and sufferers were simply burned at the stake. It was not until the 17th century, when a neurologist named Thomas Willis declared that melancholia was “a complicated Distemper of the Brain and Heart,” that medical practitioners were able to place the disease on the correct path. The treatment at that time was still similar to that of the 5th century, but at least they had begun to think of it as an illness. Along the way to modern times, treatments such as electroconvulsive therapy, chemical cocktails, herbal remedies, and a few unsuccessful experimental drugs were tried and discarded. It was not until 1957 that scientists began experimenting with some promising drugs. None were long-lived because of terrible side effects, but the process of trial and error allowed the researchers to begin to understand how the drugs worked, and ultimately provided scientists with information that enabled them to flush out what caused depression. They discovered the cause to be depleted levels of the brain’s neurotransmitters, namely serotonin, norepinephrine, and dopamine. That finding led to the discovery of Prozac in 1987. It was our first SSRI (selective serotonin reuptake inhibitor). Today we have many drugs from which to choose, but still 30% of all people with depression or depression-related illnesses are treatment-resistant.
There is an FDA approved drug presently being used by anesthesiologists called ketamine hydrochloride, which is administered to people who are having surgery in order to put them to sleep. It is unfortunately also being abused recreationally to “trip and hallucinate.” In light of its mood-altering characteristics, it is the basis for experimentation in the search for new psychopharmacological medications. Several clinical tests are taking place showing excellent results for treatment-resistant patients, which further encourages drug companies to continue financing research into ketamine’s curative possibilities. One of its major characteristics is that it apparently works quickly. Unlike the currently available selection of medications for depression and depression-related illnesses, which take from one to two months to begin to kick in, the ketamine-based drugs can have an effect in just a few hours. So progress is plainly being made in addressing the need for more effective medicinal remedies. This is great news for all of us.