BIRMINGHAM, Alabama -- Ketamine, introduced as an anesthetic in the 1970s and abused on the street as Special K, is showing promise as an effective treatment for depression in suicidal patients coming into the emergency room, University of Alabama at Birmingham researchers report.

In a one-of-a-kind study, suicidal patients entering the UAB Hospital emergency department are being treated with ketamine and it is relieving severe depression in a short time, said Dr. Richard Shelton, professor in the Department of Psychiatry and Behavioral Neurobiogy.

"What we are hoping with this emergency department study is that it will literally change how medicine is practiced in this area of care," Shelton said.

Shelton hopes ketamine would significantly reduce hospitalizations.

UAB Hospital sees about five suicidal patients a day, 150 per month. Half of those are hospitalized, which is expensive.

"With the fact that we are moving toward accountable care, one of the things we are trying to do is reduce people from having to go to the hospital," Shelton said.

Nationwide, half a million people come to the emergency department every year, he said.

"The advantage (of ketamine) is that it is so rapidly effective in so many people," Shelton said.

The depression-easing effects of ketamine can occur within 15 minutes.

Traditional antidepressants can take two to three weeks for effectiveness, and even then nearly two-thirds of the patients don't get completely well.

"The disadvantage (of ketamine) is that its effect lasts only five to seven days and you have to use IV to administer it."

A second study sponsored by Janssen Research & Development will involve treating people with severe depression and suicidal thoughts in an outpatient setting to determine how often it needs to be administered to keep its depression-lifting effects, Shelton said.

For that study, which is seeking participants, a nasal spray will be used to administer the drug.

Traditional antidepressants target two brain chemicals, norepinephrine and serotonin. Ketamine targets an entirely different brain chemical: glutamate, Shelton said.

In higher doses, ketamine has been used as an effective anesthetic, knocking patients out. It is used in this way most often in emergency departments and veterinary clinics on animals, Shelton said.

In moderate doses, ketamine provides a euphoria or a high and therefore it has a high potential for abuse. Over the years veterinary clinics have been targeted by thieves looking to obtain the drug.

But for depression treatment, the dose is low and side effects are minimal, he said.

A third trial under way at UAB is testing something called Glyx-13 by Naurex, Inc., a drug that also targets glutamate.

UAB is looking for male and female patients, from 19 to 64, who have been diagnosed with depression, to enroll in the outpatient ketamine study and the Glyx-13 study.

Those interested in more information can call (205) 975-2911.

More from UAB's Bob Shepard.