A new treatment for depression
Depression is estimated to affect 3% of the population in the UK. The total number of people with common mental health problems is reported to have increased 20% between 1993 and 2014. Reported cases of self-harm and suicidal thoughts are increasing at an alarming pace.
Depression can mean being in low spirits, but symptoms can be life-threatening and can last months.
Treatment resistant depression
A third of patients have depression which remains severe despite attempts to treat it (usually with drugs/talking therapies). Esketamine offers some hope to those patients.
It originally showed benefits in a trial in 2019 which demonstrated it was safe and effective. The trial showed that patients treated with Esketamine alongside antidepressants showed a significant reduction in severity of symptoms, compared with patients taking solely antidepressants.
A cautious introduction
It has taken a long time for the drug to become available because it has the potential to be abused or misused. It is a Controlled Substance and can only be prescribed in limited circumstances. Usage can only be within strictly designed protocols, which can take time to be developed and approved.
Although it shows benefits for patients the treatment is not readily available on the NHS. The National Institute for Clinical Excellence (NICE) deems that the cost of the drug (reportedly £10,554 per course), combined with the costs of changes in clinical practice necessary means that it is too expensive for widespread use.
Limited access privately
The Nightingale Hospital in London is the only private hospital in the UK to provide access to the therapy. Private medical insurers are reviewing applications to fund the treatment on a case-by-case basis.
Patients can self-refer. Additionally, GPs and other health professionals can also refer patients. It can be self-funded, if treatment is approved by the clinical team at the hospital.
Dr Christopher Muller-Pollard MBBS BSc MRCS MRCPsych who leads the service at The Nightingale says "I clearly remember when Prozac was introduced as a treatment in 1982 and given the large number of people who do not respond to other antidepressants, it is great news that this safe and effective treatment is now available for patients".
Although the drug has twice been rejected for approval by NICE a third assessment is currently awaiting a decision.
Wider access to the treatment would be of potentially large benefit to the thousands of people who suffer with depression every week, as well as their families, friends and employers.
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