Health Highlights: Feb. 13, 2019
FDA Panel Backs Ketamine-like Drug for Depression Counseling Can Prevent Pregnancy-Related Depression: Task Force
Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
FDA Panel Backs Ketamine-like Drug for Depression
An expert panel for the U.S. Food and Drug Administration has endorsed a drug for major depressive disorder that is a close relative to the club drug ketamine, or "Special K."
Ketamine is a powerful anesthetic used in hospitals, though recent research has shown it may help those whose depression resists treatment.
If approved by the FDA, the new drug known as esketamine would be available to patients who haven't found relief with at least two other antidepressants. The Tuesday vote was 14-2, with one member abstaining, according to CNN.
The FDA does not have to follow the recommendations of its expert panels, but it typically does. A decision is expected in early March.
Made by Janssen, a division of Johnson & Johnson, esketamine is a nasal spray medication that targets different pathways in the brain than other antidepressants do. Unlike antidepressants that can take four to six weeks to take effect, esketamine's benefits can be felt within hours or days, the FDA said. That makes it likely that esketamine might be used effectively in conjunction with an antidepressant, the agency added.
Depression can be tricky to treat, with between 30 and 40 percent of those with major depressive disorder not having success with first-line antidepressants, the agency added.
Despite the panel's approval, two of five key studies of esketamine failed to meet their primary goals. When taking esketamine, some patients experienced sedation, blood pressure spikes and dissociation (feeling disconnected from surroundings) within two hours of taking the drug, CNN reported.
Six patients died while taking esketamine in those trials, including three suicides, but agency documents concluded "it is difficult to consider these deaths as drug-related."
Because of those caveats, patients will not be allowed to pick it up at a local pharmacy; instead a health care professional would have to monitor the person during the first two hours, the news service said.
Counseling Can Prevent Pregnancy-Related Depression: Task Force
Women at risk for depression during and after pregnancy should receive certain types of counseling in order to prevent it, the U.S. Preventive Services Task Force says.
In a recommendation published in the Journal of the American Medical Association, the task force said its review of available evidence showed that women who received one of two forms of counseling were 39 percent less likely than those who didn't to develop perinatal depression, The New York Times reported.
One type is cognitive behavioral therapy that helps women manage their feelings and expectations to create healthy, supportive settings for their children. The other type is interpersonal therapy that includes coping skills and role-playing exercises to help deal with stress and relationship conflicts.
The government panel of health experts gave this recommendation a "B" rating, meaning that under the Affordable Care Act, this counseling should be covered without co-payments, The Times reported.
Perinatal depression is the most common complication of pregnancy, estimated to affect between 180,000 and 800,000 American mothers each year and up to 13 percent of women worldwide.
This is the first time that any method has been scientifically recommended to prevent perinatal depression, which occurs in as many as one in seven women during pregnancy or in the year after giving birth.
"We really need to find these women before they get depressed," said task force member Karina Davidson, senior vice president for research for Northwell Health, The Times reported.
"We're so excited to be the first to have this recommendation on preventing a really devastating, prevalent disease that causes such harm to the parent, the child and the family, both psychologically and physiologically," Davidson said. "All those consequences of this very very prevalent, stigmatizing disease can be averted by effective behavioral counseling."
Perinatal depression increases a woman's risk of becoming suicidal or harming her infant, increases the risk of premature birth or low birth weight, and can impair a mother's ability to bond with or care for her baby, according to the task force.
It also said that children of mothers who had perinatal depression have more behavior problems, cognitive difficulties and mental illness, The Times reported.
The task force said at-risk women who should receive counseling include those with: a personal or family history of depression; recent stresses like divorce or economic strain; traumatic experiences like domestic violence; and depressive symptoms that don't constitute full-blown depression.
Other risk factors include being a single mother, a teenager, low-income, not having graduated high school, and having an unplanned or unwanted pregnancy, The Times reported.