This potentially could change the landscape of how we treat depression down the road. —Dr. Howard Weeks
SALT LAKE CITY — A study conducted by University of Utah doctors could lead to a new anti-depression treatment option for patients who don't respond to medication.
"This potentially could change the landscape of how we treat depression down the road," said Dr. Howard Weeks, U. assistant professor of psychiatry and the first author of the study.
A study by the U.S. Centers for Disease Control and Prevention in 2005-06 said only 39 percent of Americans with severe depression reported contacting a mental health professional. Weeks said of those who seek help, many are unresponsive to medication.
Electroconvulsive therapy, often called shock therapy or ECT, is one of the most effective treatments for depression among patients who are medication-resistant, he said. But because of negative side effects, including memory loss and the way shock therapy is often portrayed in TV and movies, patients often opt out.
The new findings from a cross-campus collaboration of U. researchers suggest that isoflurane, a surgical anesthetic drug, could be another option for treating depression without the side effects of ECT.
Isoflurane "showed an anti-depression benefit that equaled the benefit of ECT," Weeks said. "As a psychiatrist, that is phenomenal because ECT is our gold standard."
With the new procedure, patients are intubated and are given isoflurane as if they were undergoing surgery. The dosage is increased to a level that turns off electroactivity of the brain for about 15 minutes, then patients are woken up.
"We're turning it on its head by saying, 'Is this a medicine we can actually use to treat instead of putting you to sleep so someone else can treat you?'" Weeks said.
Dr. Scott Tadler, associate professor of anesthesiology at the U., said patients are much more functional after isoflurane treatments than shock therapy treatments.
"You don't get memory loss, (and) during the treatment phase they're more alert and more functional," Tadler said.
In the study, the doctors found a 75 percent response rate to isoflurane and an 88 percent response rate to shock therapy.
Study participants had 10 treatments over a three-week period — eight received isoflurane and 12 received ECT. After one month, Weeks said both isoflurane and ECT participants still showed anti-depressant benefits.
"Certainly our results are very encouraging, but it's a very small number of people," he said. Weeks and Tadler said they plan to conduct a large-scale clinical trial.
The doctors also used Aneclear as part of their study, a device developed by three U. anesthesiology faculty members to remove anesthesia faster and reduce post-anesthesia nausea.
Weeks said it would normally take five to six hours for patients to wake up with the amount of isoflurane used, but with the Aneclear device, it takes just 45 to 60 minutes, making isoflurane much more cost-effective for patients.
If a larger study confirms their findings, Weeks said patients could possibly be treated everyday as opposed to a few times a week with ECT.
"This has some very big ramifications because if I could treat someone rapidly and get their depression under control in a couple of days, that would be huge," he said.
Tadler said if their findings are confirmed, "we could help millions of patients a year."