Choose another video or ask the site administrator to add captions.
Recently Watched
Open something you watched recently.
You May Also Like
More lessons selected from your Library.
Transcript excerpt · English
So when people find out that I study antidepressants,
they often ask,
how do they work?
And people are surprised to learn, we don't know.
And part of that surprise comes from the fact that we've been told
that depression is a chemical imbalance,
that you don't make enough serotonin.
And we know that antidepressants,
SSRIs are the most common antidepressant prescribed,
increase serotonin.
And so they think that what we're doing
is we're fixing depression by increasing serotonin.
But that's not the whole story.
In fact, that may not even be the story.
What I'm going to talk to you today about
is some of our work with ketamine,
a really remarkable drug that has rapid antidepressant effects.
And it doesn't correct a chemical imbalance.
It actually causes the brain to change, to adapt.
So when we talk about antidepressants, we first have to start with depression.
And everyone uses the term depressed.
We hear it all the time.
"I feel depressed, I feel sad, I have melancholy."
Creative expression of depression is very common.
For centuries, people have tried to express the feeling of depressed
or melancholy.
For example, Picasso, as illustrated in these paintings,
went through his blue period and his painting style changed.
It really portrayed a sense of sadness, of gloom.
We know that writers do this.
Poets, I mean, you can read a poem
and literally be moved to tears by the words.
Musicians.
How many sad songs do we hear?
Eric Clapton's "Tears in Heaven", about the loss of his son,
is heartbreaking.
But major depression is more than just sadness.
It's a serious medical condition,
especially left untreated.
Depression is really the dulling of emotion,
really losing interest
and sometimes completely withdrawing.
The symptoms of depression can vary.
Some people, it may impact more appetite,
others sleep.
It may have effects on concentration, memory.
A range of things.
So not everyone has the same symptoms.
But it's a serious illness.
Again, left untreated.
We know globally it affects over 280 million people worldwide.
So a huge number.
Everybody in this room knows someone
that's impacted by depression,
whether they tell you about it or not.
Moreover, depression is the leading cause of disability in the US.
Disability meaning really loss of productivity
both on the individual and family
and on society.
Part of the focus that comes from studying depression, though,
is really focused on antidepressants.
And we all have heard of antidepressants.
And how this came about was really completely randomly.
It was noticed that certain drugs had antidepressant effects,
and as people studied it,
they realized that if you increase serotonin,
you had an antidepressant effect.
So things like Prozac, Zoloft,
common antidepressants,
have been studied for decades,
and we've seen ads on TV,
in doctor's offices.
People openly talk about the idea we're increasing serotonin,
we're correcting our chemical imbalance.
But here's the thing.
If you look at individuals with depression,
many of them don't have decreased serotonin.
They have normal levels.
And that's a surprise to many people.
This idea that we had a measurable index of depression
just because it was less serotonin, many people talked about,
but it really wasn't true.
So that's been sort of surprising to many people.
But importantly,
SSRIs still are incredibly important treatment options.
They help many people.
They are life-changing and they are life-saving.
For many people, they really give them the will to live.
The thing about SSRIs is that when you take them,
you have this increase in serotonin very quickly,
but they take weeks to work.
They don't work quickly.
And so why do they take weeks to work?
And that's the part that we really don't know.
But again, they increase serotonin.
So if it was simply fixing, it should happen quickly.
And so while again, they're incredibly important treatments,
they are life saving.
And if you're on an SSRI, you should continue to take your SSRI.
That's an important message.
But that's why some of the research
I’m going to talk to you today about ketamine,
which my lab and group has been studying now
for more than 15 years, has been so remarkable.
Ketamine, this is the structure of the drug.
What's been noticed is,
in a clinical study that had nothing to do with depression,
it was just an observation,
they gave a low dose of ketamine.
And some of you may have heard of ketamine.
At high levels, it's an anesthetic,
at more mid-level doses it's a party drug.
But what they were doing was a study with an incredibly,
incredibly low dose.
And for those individuals that were depressed
that received ketamine,
they had a rapid antidepressant effect --
not within weeks, within hours.
We didn't even know it was possible
to have an antidepressant effect that rapidly.