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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Scottish Labour's defeat to the Tories confirms a political transformation

The defining divide is no longer between left and right but between unionist and nationalist.

It was Scotland where Labour's recovery was supposed to begin. Jeremy Corbyn's allies predicted that his brand of left-wing, anti-austerity politics would dent the SNP's hegemony. After becoming leader, Corbyn pledged that winning north of the border would be one of his greatest priorities. 

But in the first major elections of his leadership, it has proved to be Labour's greatest failure. A result that was long thought unthinkable has come to pass: the Conservatives have finished second (winning 31 seats). For the first time since the 1910 election, Labour has finished third (winning 24). Scottish Labour leader Kezia Dugdale stood on a left-wing platform, outflanking the SNP on tax (pledging to raise the top rate to 50p and increase the basic rate by 1p), promising to spend more on public services and opposing the renewal of Trident. But rather than advancing, the party merely retreated.

Its fate confirms how Scottish politics has been realigned. The defining divide is no longer between left and right but between unionist and nationalist. With the SNP as the only major pro-independence party, the Tories, led by the pugnacious Ruth Davidson, framed themselves as the pro-UK alternative - and prospered. In contrast, Dugdale refused to rule out supporting a second referendum and suggested that MPs and MSPs would be free to campaign for secession. The result was that Scottish Labour was left looking dangerously irrelevant. "Identity politics. Labour doesn't get it," a shadow minister told me. Its socialist pitch counted for little in a country that remains ideologically closer to England than thought. The SNP has lost its majority (denying it a mandate for a second referendum) - an outcome that the electoral system was always designed to make impossible. But its rule remains unthreatened. 

Corbyn's critics will seek to pin the baleful result on him. "We turned left and followed Jeremy's politics in Scotland, which far from solving our problems, pushed us into third," a senior opponent told me. But others will contend that a still more left-wing leader, such as Neil Findlay, is needed. Dugdale is personally supportive of Trident and was critical of Corbyn before his election. Should she be displaced, the party will be forced to elect its sixth leader in less than five years. But no one is so short-sighted as to believe that one person can revive the party's fortunes. Some Corbyn critics believe that a UK-wide recovery is a precondition of recovery north of the border. At this juncture, they say, SNP defectors would look anew at the party as they contemplate the role that Scottish MPs could play in a Westminster government. But under Corbyn, having become the first opposition to lose local election seats since 1985, it is yet further from power. 

In Scotland, the question now haunting Labour is not merely how it recovers - but whether it ever can. 

George Eaton is political editor of the New Statesman.