Capsules containing ketamine. Photo: Nicolas Asfouri/AFP
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Could ketamine stop suicide?

The drug has been proven as a reliever of suicidal thoughts. With some doctors reluctant to prescribe SSRIs, it could provide the answer.

If suicide is the question, could ketamine be the answer? Nick Clegg has suggested suicide is avoidable in a well-structured NHS, but targeting the right people remains a complex issue.

It’s not just about depression, as the case of a 65-year-old woman who made a shocking announcement to her doctors demonstrated. “I’m fed up with life, I’ve had enough,” she said. “I don’t want to live any more . . . I no longer wish to live, to see anything, hear anything, feel anything . . .”

This was shocking because the feelings were induced not by depression, but by electrical stimulation of the brain. It was an unexpected side effect of an experimental treatment for Parkinson’s disease.

Applying a current through electrodes implanted in the patient’s brain was meant to alleviate tremors; instead, it brought on suicidal thoughts within five seconds, and 90 seconds after turning it off they were gone. Then came roughly five minutes of euphoria and general larking about.

This remarkable finding, reported in the New England Journal of Medicine in 1999, was one of the first to suggest that suicide and depression are not as inextricably linked as we might imagine.

We have more recent data, too. Ten years have passed since we discovered a link between suicidal thoughts and the antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Doctors became much more wary about prescribing SSRIs but the results were not as we’d hoped.

A Swedish study found that after warnings about SSRIs were issued in 2004, the suicide rate among ten-to-19-year-olds increased for five consecutive years – the largest group being those who were not prescribed antidepressants. In the US, child and adolescent suicide rates have risen by 14 per cent.

Two US-based researchers, Robert Gibbons and J John Mann, argue it is time to review the FDA warning. Writing in the Psychiatric Times, they point out that subsequent research has shown a complex relationship between suicide contemplation, depression and antidepressants. The result of the warning has not been a lower suicide rate. “Instead, we see fewer antidepressant prescriptions, an increase in youth suicides, and negative effects on human capital.”

The Parkinson’s patient’s experience – especially, perhaps, the euphoria and larking about – suggests that ketamine, the newest route to alleviating suicidal thoughts, might be more successful.

Most people know ketamine – if they know it at all – as a party drug. Though it was first developed as an anaesthetic, it can elicit euphoria at lower doses. We now know, thanks to a study published in the Journal of Psychiatric Research in December, that ketamine is also a useful reliever of suicidal thoughts.

By giving 133 patients a dose of ketamine, researchers teased apart the links between suicidal thoughts, depression and anxiety, and they found that, although ketamine does relieve depression and anxiety, its effect on suicidal ideation is far stronger than on either of these. The effect is rapid – some patients report their contemplation of suicide gone within a couple of hours. According to a report in Nature, many pharmaceutical companies are now accelerating their ketamine research.

There are plenty of wrinkles to iron out. How would we set the threshold of eligibility? And how much autonomy do we give people? Where people are under the care of the state, all means for suicide are removed from those deemed at risk. Would we sanction a ketamine shot – or a routine of ketamine shots – as a mandatory measure to be used along with removal of belt and shoelaces? Or for anyone deemed to be a danger to themselves? If Clegg gets his way, we may soon find out. 

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 23 January 2015 issue of the New Statesman, Christianity in the Middle East

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Both Labour and the Tories have decided the 2017 election was a victory

As Westminster heads for the beach, at least one party is on course to look very foolish.

For the second time in seven years, Westminster heads for the beach after an election that no one won.

Jeremy Corbyn went into the election looking for “brilliant defeat” and he got it – a triumphant advance for him and his party, and with it, the Labour leadership for however long he wants it. Now most of his party seems to have remembered the brilliance, and forgotten the defeat.

Fortunately or unfortunately, there is a thriving cottage industry among the right-wing commentariat that is very keen to remind us all that Labour lost the election. This is certainly true, but it's also true that the party turned around a catastrophic picture as far as both the polls and local elections were concerned, and emerged with an electoral map that, unlike the grim vista Corbyn inherited from Ed Miliband, suggests that defeat for the Conservatives might be accomplished in ten months not ten years. So, yes, not a defeat of the Tories. But still a result with something to cheer for Labour.

The version of history being spun by the leader's office: that the 40 per cent of the vote Corbyn got in 2017 is part of the general unravelling of the English-speaking establishment that we saw with the votes for Donald Trump and Brexit, and that the tide of history is moving their way, isn't implausible. Certainly, I'm yet to meet anyone at Westminster willing to bet large sums of money that Corbyn won't end up in Downing Street these days.

Team Corbyn at least have something resembling a narrative. On the Conservative side, what looks to be happening now is that a large chunk of the right has told itself what went wrong is that they didn't talk about austerity enough, and that a bunch of 30- and 40-somethings decided to vote Labour because of something Corbyn said about tuition fee debt in the NME.

It's true that the new operation at Downing Street has proved that it can successfully drive the story in the right-wing press. Labour's flat-footed response to the non-story did expose vulnerabilities in the opposition's set-up. But while showing they can launch a rocket of any kind is a big step up for the post-Cameron Conservatives, it should worry that party that they don't seem to have noticed that this one didn't have a ballistic payload attached. Labour may be better prepared next time.

The contrast with 2010 is marked. As one minister pointed out to me recently, after that contest, centre-right think tanks bustled with activity and ideas. Conservative Party conference was full of suggestions about what they'd do if they won a majority. An extensive post-mortem into “what went wrong” – after an election in which the Tories gained 97 seats in one night, a post-war record for that party – occurred, both publicly and privately.

It might be that I'm not as fashionable as I was two years ago, but I was invited on to more panels discussing how the Tories could do better after the 2015 election, a contest they won, than I have in 2017, after an election they lost. Policy Exchange, that old generator of Cameron-era ideas, seems to be focused on foreign policy nowadays. As for the rest of the right-wing think tanks, they are almost entirely devoted to position papers telling us all that Brexit is going brilliantly.

It's not entirely fair to say that after 2010, the Conservatives recognised they'd lost and tried to fix it, while Labour decided the 2010 election had been a type of victory and tried to re-run it in 2015, but there is more than a grain of truth in that statement. At the moment, it looks as if both parties have decided that the 2017 election was a victory and that “once more, with feeling” is all they need to get over the line next time. At least one side is on course to look very foolish. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to domestic and global politics.