Capsules containing ketamine. Photo: Nicolas Asfouri/AFP
Show Hide image

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

Getty Images.
Show Hide image

PMQs review: Jeremy Corbyn turns "the nasty party" back on Theresa May

The Labour leader exploited Conservative splits over disability benefits.

It didn't take long for Theresa May to herald the Conservatives' Copeland by-election victory at PMQs (and one couldn't blame her). But Jeremy Corbyn swiftly brought her down to earth. The Labour leader denounced the government for "sneaking out" its decision to overrule a court judgement calling for Personal Independence Payments (PIPs) to be extended to those with severe mental health problems.

Rather than merely expressing his own outrage, Corbyn drew on that of others. He smartly quoted Tory backbencher Heidi Allen, one of the tax credit rebels, who has called on May to "think agan" and "honour" the court's rulings. The Prime Minister protested that the government was merely returning PIPs to their "original intention" and was already spending more than ever on those with mental health conditions. But Corbyn had more ammunition, denouncing Conservative policy chair George Freeman for his suggestion that those "taking pills" for anxiety aren't "really disabled". After May branded Labour "the nasty party" in her conference speech, Corbyn suggested that the Tories were once again worthy of her epithet.

May emphasised that Freeman had apologised and, as so often, warned that the "extra support" promised by Labour would be impossible without the "strong economy" guaranteed by the Conservatives. "The one thing we know about Labour is that they would bankrupt Britain," she declared. Unlike on previous occasions, Corbyn had a ready riposte, reminding the Tories that they had increased the national debt by more than every previous Labour government.

But May saved her jibe of choice for the end, recalling shadow cabinet minister Cat Smith's assertion that the Copeland result was an "incredible achivement" for her party. "I think that word actually sums up the Right Honourable Gentleman's leadership. In-cred-ible," May concluded, with a rather surreal Thatcher-esque flourish.

Yet many economists and EU experts say the same of her Brexit plan. Having repeatedly hailed the UK's "strong economy" (which has so far proved resilient), May had better hope that single market withdrawal does not wreck it. But on Brexit, as on disability benefits, it is Conservative rebels, not Corbyn, who will determine her fate.

George Eaton is political editor of the New Statesman.