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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How Theresa May laid a trap for herself on the immigration target

When Home Secretary, she insisted on keeping foreign students in the figures – causing a headache for herself today.

When Home Secretary, Theresa May insisted that foreign students should continue to be counted in the overall immigration figures. Some cabinet colleagues, including then Business Secretary Vince Cable and Chancellor George Osborne wanted to reverse this. It was economically illiterate. Current ministers, like the Foreign Secretary Boris Johnson, Chancellor Philip Hammond and Home Secretary Amber Rudd, also want foreign students exempted from the total.

David Cameron’s government aimed to cut immigration figures – including overseas students in that aim meant trying to limit one of the UK’s crucial financial resources. They are worth £25bn to the UK economy, and their fees make up 14 per cent of total university income. And the impact is not just financial – welcoming foreign students is diplomatically and culturally key to Britain’s reputation and its relationship with the rest of the world too. Even more important now Brexit is on its way.

But they stayed in the figures – a situation that, along with counterproductive visa restrictions also introduced by May’s old department, put a lot of foreign students off studying here. For example, there has been a 44 per cent decrease in the number of Indian students coming to Britain to study in the last five years.

Now May’s stubbornness on the migration figures appears to have caught up with her. The Times has revealed that the Prime Minister is ready to “soften her longstanding opposition to taking foreign students out of immigration totals”. It reports that she will offer to change the way the numbers are calculated.

Why the u-turn? No 10 says the concession is to ensure the Higher and Research Bill, key university legislation, can pass due to a Lords amendment urging the government not to count students as “long-term migrants” for “public policy purposes”.

But it will also be a factor in May’s manifesto pledge (and continuation of Cameron’s promise) to cut immigration to the “tens of thousands”. Until today, ministers had been unclear about whether this would be in the manifesto.

Now her u-turn on student figures is being seized upon by opposition parties as “massaging” the migration figures to meet her target. An accusation for which May only has herself, and her steadfast politicising of immigration, to blame.

Anoosh Chakelian is senior writer at the New Statesman.

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