Looking at images of people smiling at you extends ketamine's antidepressant effects

Simple Computer-Based Neurocognition Training — using positive words and pictures aimed at boosting self-worth — prolongs the antidepressant effects of ketamine in people with treatment-resistant depression, University of Pittsburgh researchers reported today in The American Journal of Psychiatry .

Results of a double-blind, randomized clinical trial in Pittsburgh demonstrate brain plasticity after a single dose of ketamine The enhanced window may help manage depression for at least a month. These findings are an important step toward long-term treatment of depression in patients who have exhausted other options.

“Using simple in the period following ketamine treatment, when the brain is receptive to absorbing new information, we You can look for key features of depression,” said Dr. Rebecca Price, associate professor of psychiatry at the Pitt School of Medicine. “Training the brain to associate its own perceptions with positive thoughts in this window of ketamine-induced plasticity exceeded my expectations. I was amazed and amazed at such clear findings from such a trivial intervention.”

Nearly 21 million U.S. adults experienced at least one major depressive disorder in 2020, according to an analysis by the National Institute of Mental Health attack. About 9 million adults are diagnosed with depression each year and nearly 3 million people do not respond to traditional antidepressants. For people with this treatment-resistant depression, psychoactive drugs such as ketamine offer an alternative opportunity for long-term relief.

Since the antidepressant effects of ketamine were first reported in the medical literature nearly two decades ago, intravenous ketamine has been offered The clinics have expanded from academic medical centers to specialty clinics across the country. When administered and properly monitored in a healthcare setting, the infusion is safe and does not induce drug dependence, while providing therapeutic benefits for patients with treatment-resistant depression.

But treatment has its limitations. Although symptom relief can be felt as early as two hours after the infusion, the effects of ketamine tend to wear off within the next few weeks, prompting the patient to repeat the infusion. Ketamine infusions are associated with high out-of-pocket costs and often have long waiting lists, so not all patients who might benefit from the treatment get it.

Price, whose research focuses on identifying neurocognitive mechanisms of mood and anxiety disorders, was the first to show that intravenous ketamine One of those who can reduce suicidal thoughts. Now, she and her team are focused on increasing the accessibility of ketamine therapy and expanding its clinical potential by pairing the drug with a digital computer-based therapy.

“We are interested in creating automated interventions that any computer or device can run, making it as accessible as possible, ‘ Price said. “Our goal was to leverage digital technology and develop a strategy to effectively extend the time between appointments, save patients money and allow more patients to access effective depression care.”

The strategy developed by Price combines a single ketamine injection with automated computer-based training that uses positive words and images to influence how a person sees themselves . The words “sweet,” “cute,” and “worthy” appeared on the screen, along with pictures of patients and images of smiling people.

The clinical trial enrolled more than 150 adults with treatment-resistant depression. Following the ketamine infusion, one group of patients completed eight 20-minute sessions over four days, while the other received a non-therapeutic computer task. The third group received a saline infusion followed by active training. Over the following month, those in the ketamine plus training group reported feeling less depressive symptoms for less time than those who received no training or ketamine, suggesting that neurocognitive training prolongs ketamine resistance Depressive effect.

Based on these promising initial findings, Pitt’s Institute for Innovation has filed an application for this novel treatment Provisional Patent. Now, researchers are testing whether training on an iPad or smartphone provides the same benefits as training done on a computer in a clinic. Ongoing research is also exploring how similar techniques can help with suicidal tendencies, and future research may expand to include anxiety, eating disorders, and more.

“This automated intervention is so simple that it can be repurposed to address a variety of mental health conditions and can be easily adjusted to meet the needs of individual patients,” Price said. “If you can maintain responses and reliably relieve depression for a month by playing a small number game, that’s already an improvement on the status quo.”