The Evolution of Antidepressant Treatment


J. John Mann, MD, gives a brief overview of where we are now in treatment of major depressive disorder.

Although major depressive disorder is a prevalent disability affecting millions of adults nationwide, treatment for its symptoms has developed drastically over the past few years.

In an interview with HCPLive®, J. John Mann, MD, Professor of Translational Neuroscience, Columbia University, discussed how far research has evolved in its treatment of affected patients.

According to him, early antidepressant medication was ineffective and slow to treat. It took weeks for patients to experience antidepressant effects, and only about half benefitted from such treatment.

He highlighted recent research into ketamine, a drug originally used for anesthetic purposes, as an important milestone for treatment. Specially, he noted its exceptionally quick antidepressant effect, efficacy in treatment-resistant patients, and profound impact on those with suicidal thoughts and ideation.

Mann explained that the current use of ketamine as an antidepressant evolved haphazardly out of various, uncontrolled studies.

He cited one study where investigators at Yale University accidentally discovered ketamine’s antidepressant properties while treating patients with schizophrenia.

Although much research had produced robust data for the anesthetic drug’s effectiveness in treating symptoms of major depressive disorder, no trial had systematically examined proper dosage before.

“When you use a medication, usually the first thing you do is discover whether it is safe to use in human beings,” he said. “The second thing you do is find out what the right dose is. In many ways, the public is getting used to this approach because they are learning it from the development of COVID-19 vaccines.”

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