If you ask adults with chronic depression about when they first experienced a major depressive episode, there is a good chance they will point to their adolescence.
Teenagers, just like adults, often don’t respond adequately (or at all) to traditional anti-depressants.(Carandang, 2013)
While studies have found that ketamine can help adults with treatment-resistant depression (TRD), until recently, research on how adolescents respond to this novel treatment has been largely absent.
Teens and Depression: An Underdiagnosed Epidemic
All too often, depression in teens goes undiagnosed and untreated because adolescents are seen as naturally moody and sullen.
As a study of almost 10,000 teens found, this lackadaisical attitude towards teen depression is incredibly dangerous:
As underrecognized and undertreated as depression is among adults, it is even more so among children and adolescents.(Saluja et al., 2004)
Overlooking depression among youths can have tragic consequences.
- Those who experience depression at an early age often struggle with depression throughout their lives, (Lewinsohn, Rohde, Klein, & Seeley, 1999) and in many cases, early onset of depression predicts more severe depression during adulthood.(Weissman et al., 1999)
- Even subclinical depression during adolescence increases the risk of depression as an adult 2- to 3-fold.(Pine, Cohen, Gurley, Brook, & Ma, 1998)
- Depression is associated with an increased risk of suicide,(Birmaher et al., 1996) and teen suicide rates are about triple what they were in 1950.(1)
Study Finds Ketamine Helps Teens with Depression
Given that teenage depression is a major problem, but many patients don’t respond to standard antidepressant medications, it is clear adolescents with TRD need other options.
Researchers at the University of Minnesota are currently studying if ketamine could help these teens. While research is ongoing, they just released preliminary results.(2)
The sample size thus far is small, but among the ten teens with TRD studied, 4 were considered responders. This means the overall response rate in adolescents (40%) in this study was significantly lower than has been found in adults (70.8%).
However, it is important to note that researchers define a responder as a patient who scored a 50% or larger reduction in depression scores. Even non-responders showed slight improvement overall with an average of 22% reduction in scores.
However, amongst teens who are considered responders, ketamine seems to have worked remarkably well. The duration of antidepressant effects in adolescents (>42 days) was significantly longer than what has been reported in adults (~18 days)(Murrough et al., 2013).
Moreover, the average improvement seen in adolescent responders was a robust 74%, with the strongest improvements in:
- Lassitude (lack of energy)
- Reported sadness
- Inability to feel
- Pessimistic thoughts
Researchers theorized that teenagers might enjoy sustained anti-depressant effects from the infusions “due to the versatility of the growing adolescent brain allowing the ketamine to work more efficiently.”
It is unclear why current results show that the use of ketamine in adolescents with treatment-resistant depression did not yield a response rate as high as adults, but it important to highlight the study thus far has been very small. Researchers noted that “more studies are required.”
Case Report: Ketamine Helps Suicidal Teen
In addition to this study, a recent case report by Yale researchers on the successful treatment of a 16-year-old boy diagnosed with major depressive disorder (MDD) suggests ketamine may be a life-saving treatment.(Dwyer et al., 2017)
This patient had failed multiple anti-depressant medications and psychotherapy trials and had made three serious suicide attempts.
“He presented as hopeless about the prospect of psychiatric improvement and complained of persistent thoughts of wanting to die,” wrote Jennifer B. Dwyer, MD, PhD, Clinical Fellow at Yale.(3)
The boy received seven infusions over an eight-week period. His depressive symptoms were reduced and he no longer reported suicidal ideation. He has returned to school with substantial functional improvement.
Ketamine Therapy Can Help Adolescents
Studies on the effectiveness of ketamine therapy to treat depression in teens may be new, the use of ketamine in the adolescent population is not. Ketamine has been widely used as an anesthetic for surgical procedures for decades and its safety in children has been widely demonstrated.(Dolansky, Shah, Mosdossy, & Rieder, 2008)
Given the urgent need for new treatment options, doctors are currently using ketamine therapy to treat adolescents with depression.
“With suicide being the second leading cause of death in teens, current treatments are not adequate or able to address many of our children’s needs. I believe ketamine can make a stunning impact on adolescent depression and anxiety much like it has on adults,” said Dr. Henry Liang of the Klarity Clinic of Las Vegas.
Researchers also seem hopeful that ketamine therapy may help curb the epidemic of teen suicide. “The anti-depressant effects of ketamine could provide a massive leap forward in public health and the struggle to find advanced neurobiological treatments”, concluded University of Minnesota researchers.