Psychiatry Research at Iowa: Way Ahead of the Curve

I’m a clinically oriented psychiatric hospitalist at The University of Iowa Hospitals and Clinics, and I’m interested in the research going on here, which is always way ahead of the curve. One protocol that immediately caught my eye is Dr. Laurie McCormick’s “Ketamine Augmentation of Electroconvulsive Therapy (ECT) for Patients with Depression.” The description follows:

“This is a randomized controlled trial of ketamine versus anesthesia as usual during ECT procedures in unipolar or bipolar depressed patients (male or female, ages 26-60) being treated with ECT. This study involves neuropsychological testing before and after the 6th (or final) ECT treatment along with clinical assessments of depressive symptoms before, after the 6th ECT and within a week of completing a series of ECT.”

OK, so I’ve posted about this before and I’ll admit I was a little less than enthusiastic about Ketamine by itself as an instant cure for depression, see link Momma Said There’d Be Days Like This « The Practical Psychosomaticist: James Amos, M.D. But hang on, Dr. McCormick’s study takes a much safer and elegant approach, which is to add it to ECT, an already well-studied and extremely effective treatment for depression. It’s intuitive appealing to augment ECT with Ketamine, for which there is a great deal of research evidence supporting its potential usefulness for depression as well.

Some remarks from Dr. McCormick, MD and Dr. James Beeghly, MD were intriguing:

“Previous studies have found that ketamine may enhance the antidepressant response to ECT, possibly be neuroprotective against memory problems during ECT, and is actually quite safe. Our study here will continue for the next year before we have a large enough sample to determine whether all of these 3 factors are true. I did get several e-mails inquiring about the use of ketamine alone for the treatment of depression a few weeks ago. We’d prefer to see the results of studies comparing ketamine injections alone for depression as well as the result of our study using ketamine with ECT before considering routine use of ketamine outside of the FDA indication as an anesthetic.”

Another exciting protocol by Daniel O’Leary, PhD, is “Marijuana Use and Schizophrenia.” The protocol:

“The primary goal of this study is to learn more about the manner in which smoking marijuana changes mental activities and blood flow in the brain.  We are seeking individuals between the ages of 19 and 55 who have a diagnosis of schizophrenia or schizoaffective disorder.  Participants must use marijuana regularly (at least 4 times a month for at least 1 year).  Volunteers also must be willing to undergo a P.E.T.  Imaging and MRI scan.  Study will last approximately 3 visits totalling 7-8 hours. Compensation is available.”

I guess some of you can remember my posts about marijuana as well:

Let Somebody Else Bogart That Joint, My Friend « The Practical Psychosomaticist: James Amos, M.D.

Watch Out, Here’s a Caveat about Medical Marijuana–Cannabinoid Hyperemesis Syndrome! « The Practical Psychosomaticist: James Amos, M.D.

It makes sense to me to gather more information about what marijuana is doing to the brain in those who have schizophrenia and schizoaffective disorders because there is high comorbidity of substance use in patients who have these mental illnesses. If state legislatures are going to consider legalizing marijuana, then lawmakers need as much information as they can get their hands on about all the issues including the medical issues.

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Comments

  1. Jess Fiedorowicz says:

    Dr. Amos,
    Thanks for highlighting some of the exciting work being done at Iowa. It is an exciting time to be in psychiatry and at Iowa!

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    • You are so welcome, Dr. Fiedorowicz! And I might add, for the benefit of readers, that Dr. Fiedorowicz himself is in the vanguard of important research in Psychosomatic Medicine, which I’m hoping you’ll share with us real soon, Jess.

      Best,

      Jim

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