Jeremiah Franks has battled depression and anxiety his whole life.
As a child, he kept mainly to himself.
As an adult, he struggled to complete courses in higher education and lacked a career focus.
The Phoenix resident tried exercise, diets, therapy and enough medicines to fill a pharmacy. But nothing seemed to work.
“I basically white-knuckled through it,” said Franks, 32.
Then, he learned that Depression Recovery Centers in Scottsdale was developing a system using the drug ketamine to fight depression. He gave the treatment a try.
“Holy cow, I felt like I wasn’t depressed for the first time in my life. It was a completely foreign feeling to me,” he said. “After that second treatment, everything seemed so easy.”
Ketamine may seem like an unlikely treatment for depression, considering it’s better known as an anesthetic and was a popular rave drug in the 1990s.
But earlier this month, Depression Recovery Centers opened to treat people who have chronic depression with the drug, one of about eight clinics nationwide that focus on ketamine treatment for depression, according to clinic officials.
Founder Gerald Gaines said ketamine is not a first-line treatment but an option for chronic sufferers.
He said 130 successful treatments have been administered at the clinic, with most patients reaching “minimal depression” at two months — a scoring someone without depression would receive.
Currently, the clinic is treating eight patients, with at least nine successfully treated.
Capacity at the clinic is about 300 patients.
“If you can get better with therapy or fitness, you should do it,” Gaines said. “But for those who are bipolar, or for those who have found no relief from other options, ketamine could reduce ‘suicidality.’ ”
For years, the drug has been used as an anesthetic for humans and especially for animals. In the 1990s, the drug’s hallucinogenic properties made it popular to use in high doses at all-night parties, where it was known primarily as “K” or “Special K.”
Ole Thienhaus, chair of the University of Arizona’s department of psychiatry, acknowledged that the use of ketamine to treat severe depression is not mainstream but added that interest is on the rise. He said the drug’s use as an anesthetic for humans isn’t as common because of complaints of hallucinations, which, conversely, make it attractive as a party drug when used in high doses.
“Ketamine being used for depression is an interesting development,” Thienhaus said. “This knowledge has become more prevalent in the last two years or so.”
Dr. Timothy Lineberry, medical director of Mayo Clinic psychiatric hospital in Rochester, Minn., said it’s a burgeoning area of research.
In June, the Mayo Clinic released a study that found low-dose intravenous infusions of the drug given over a long period are an effective treatment for depression.
About a decade ago, researchers discovered that ketamine had the potential to alleviate severe depression. However, Lineberry said, it can also have serious psychiatric side effects, including hallucinations and drowsiness or dizziness. There are also concerns about abuse of the drug.
A significant question that must still be addressed is determining which patients will respond best to the treatment, he said.
“I expect a lot of research to come out of this area,” Lineberry said. “But from our perspective, more needs to be learned before implementing it in clinical practice.”
Lineberry would not comment on the Scottsdale clinic.
Gaines said the drug’s lack of a patent, which expired about 20 years ago, is an obstacle to bringing ketamine into the mainstream.
Ketamine is legally approved by the Food and Drug Administration, but manufacturers can only market it for its approved use: as an anesthetic.
“Drug companies can research it, and have, but they can’t publicly say that it works for depression,” Gaines said. “The lack of a patent is a hindrance because, in this case, it makes it illegal for drug companies to advertise, promote or support it for depression.
“In a quirk in the law, an independent clinic like Depression Recovery Centers can advertise and promote ketamine for depression.”
Antidepressants raise the brain’s levels of serotonin, which are chemicals associated with well-being.
However, Gaines said that instead of influencing the activity of serotonin, ketamine works to help regrow damaged cells themselves.
He said a depressed brain contains neurons that are damaged, and properly administering low doses of ketamine intravenously can cause the cells to regrow. Regeneration of neurons results in increasing levels of neurotransmitters that together can result in up to a 70 percent chance of relief from depression-related symptoms, Gaines said.
A single treatment at Depression Recovery Centers is $750. Treatments are not covered by insurance, but clinic officials will probably apply this fall to serve Medicare and Medicaid patients.
“Patients first start out treatments three days apart, and the time is extended as their mood stabilizes with additional treatments and therapy,” Gaines said.
Psychologist Ellen Diamond, who is affiliated with the clinic, said at first she was skeptical about ketamine’s ability to provide rapid relief from depression.
She said psychiatrists are slow to endorse the drug because they lack familiarity. Many providers are conservative about their referrals and don’t want to recommend something they know little about, she said.
Ketamine works quickly compared with antidepressants, Diamond said, adding that some people respond in hours, while others take a day or two, or even a couple of treatments.
“I thought it was too good to be true, but we now have another option,” she said. “If a patient is being well-served by Zoloft or Prozac, they might want to continue with that treatment. But some have tried everything and still are struggling. Ketamine could be the next step for them.”
Franks, who was one of those still-struggling patients, said he was hospitalized last year after admitting he planned to commit suicide. Nothing helped until he was treated with ketamine. Before, he could barely go to class.
Now, he’s about to graduate from Arizona State University with a degree in conservation biology.
Officials at the clinic said Franks has been “minimally depressed” for the last three months, compared with being “severely depressed” when he began treatment in December.
Franks said he’s not the only success story.
“It’s been a dramatic improvement,” he said. “Ketamine should be on the tip of every psychiatrist’s pen and should be in every ER for suicidal patients.”
