A well-known “party drug” could help Johnson & Johnson (JNJ, Financial) gain entry into the huge market for antidepressant drugs.
The company is seeking government approval in the U.S. and the European Union for esketamine, its form of the drug ketamine. In clinical trials, esketamine was effective for treating people with severe depression, including suicidal tendencies. According to a report from Florida-based Zion Research, the global depression drug market was valued at more than $14.5 billion in 2014 and is expected to generate revenue of $16.8 billion by end of 2020.
Ketamine is controversial, to say the least. It’s an anesthetic that’s best known for diminishing awareness through hallucination. It has been around since 1965, when it was developed as a derivative of phencyclidine (PCP), a powerful psychotropic that goes under the street name “angel dust.” Ketamine became a popular substitute for PCP at “raves,” semi-spontaneous parties that included techno music, dancing and drugs. A liquid or powder version of the drug, knows to ravers as “Special-K,” is either smoked or snorted.
Despite its unsavory reputation among many, ketamine is on the World Health Organization’s list of “essential drugs.” It was deemed critical because two out of three patients with depression do not fully recover on an antidepressant medication, according to findings from the largest clinical trial study of treatments for major depressive disorder, which was funded by the National Institute of Mental Health.
The J&J version shares no anesthetic or hallucinogenic properties of the original ketamine. A low dose of the drug is given through a nasal spray to affect the neural pathways in the brain. Researchers at Yale University described the effect as “rejuvenating the connections between brain cells that have been damaged by stress and depression.”
A major advantage of esketamine and other ketamine-based drugs are their quick action. Current antidepressives usually take days or weeks to produce noticeable effects, while ketamine versions can work within hours.
The excitement over ketamine shows how badly new depression drugs are needed, said Thomas Insel, director of the U.S. National Institute of Mental Health, in an article in Scientific American. Many drug companies have closed their mental-health divisions in the past five years and there have been no significant advances in depression medications in decades. The drug that has become synonymous with antidepressants in popular culture is Prozac, which was developed by Eli Lilly (LLY) and has been prescribed since 1986.
J&J isn’t the only company striving to develop patentable forms of the drug. Allergan (AGN) spent $560 million to acquire Naurex, an Illinois-based biopharmaceutical company whose primary products are two clinical-stage ketamine-like drugs. And newly public Cerecor (CERC) is developing a pill that replicates ketamine’s effects.
The enthusiasm over ketamine’s prospects is tempered somewhat by the fact that the drug’s potency and potential for both short- and long-term side effects make it problematic to formulate for specific psychological uses. Nevertheless, hopes remain high that more derivatives like esketamine will overcome some of the more powerful side effects but retain the drug’s effectiveness.
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