Alan Ferguson’s depression became so severe this spring, he quit his job, gave away his dog and planned to end his life. None of the medications he had tried eased his despair.
A psychiatrist suggested one last treatment: ketamine, an anesthetic known as “special K,” a party, or date-rape, drug.
After one infusion, Ferguson’s mood lifted. Additional sessions have provided continued relief.
“My whole life, in my free time, my brain has gone to, ‘I need to be dead,’” said Ferguson 54, who lives in Daleyville, south of Mount Horeb. “The next morning, I waited for those thoughts. They just didn’t come.”
Ketamine and other psychedelic drugs, which researchers explored in the 1960s as ways to expand or calm the mind, are making a resurgence in medicine, including at UW Health.
About three dozen patients have taken ketamine for depression at UW Hospital since last year. A campus study of psilocybin, the hallucinogenic ingredient in “magic mushrooms,” found the drug to be safe in healthy volunteers. Researchers are planning trials of psilocybin for people with depression or addiction to opioids or methamphetamine.
The university is part of a new national study looking at MDMA, better known as the street drug ecstasy, for post-traumatic stress disorder. The Food and Drug Administration has already labeled the drug a “breakthrough therapy” for PTSD.
“These are extremely potent psychoactive compounds,” said Dr. Steven Garlow, a UW Health psychiatrist who has been treating Ferguson and others with ketamine. “It seems perfectly reasonable, in a responsible fashion, to look at how they can be used in a beneficial way.”
Psilocybin, MDMA and most other psychedelics are illegal and not approved for any medical condition. They are officially available only in research settings.
Ketamine, however, is approved by the FDA as an anesthetic. That means doctors can use it in other ways, such as for depression.
‘Like flipping a switch’
Garlow has been giving ketamine to patients with depression since 2012, when he was at Emory University in Atlanta. After coming to UW Health in 2015, he started a ketamine program in Madison early last year.
The treatment is for patients with severe depression, for whom other drugs don’t work. Over three weeks, they get up to six 40-minute infusions, which leave them dazed for an hour or two. Some later get maintenance treatments every few weeks.
For more than a third of patients, ketamine doesn’t help, Garlow said. For another third, it provides a minimal benefit, he said. For about 25 percent, the improvement is dramatic.
“It’s like flipping a switch,” Garlow said. “Their depression has gone totally away.”
For Ferguson, who was diagnosed with depression at age 18, ketamine has been a life saver. A former police officer who has also worked in information technology, he had taken more than a dozen medications for depression, with little effect.
In May, he cancelled therapy and psychiatry appointments and picked a day to die. He gave his sister a farewell phone call, not telling her about his suicide plan.
But his psychiatrist connected him with a ketamine clinic in Milwaukee. After a few infusions there, Ferguson started receiving the treatments at UW Hospital. He’s now getting one every two weeks.
Some people report hallucinations from the infusions, but Ferguson said he senses more of a numbness. “Your whole body feels like it’s on Novocaine,” he said.
Early this summer, when he went five weeks between treatments, his negative thoughts crept back. But today, he feels well, with enough mental energy to help upgrade his church building and train to become a peer support specialist.
“I’m able to focus and concentrate like I haven’t been for quite a while,” he said. “To live with that for 40 years and have it be gone ... is medically incredible.”
Psilocybin and MDMA
UW-Madison’s psilocybin study, conducted at the School of Pharmacy in 2015, involved a dozen people who took escalating doses of the drug over several months. In a tranquil treatment room filled with colorful artwork, guides who are experienced in meditation assisted the subjects as they experienced their “trip.”
There were no significant side effects, and a standard dose of psilocybin seemed to work for most people, the study found. The goal is to use the drug to reduce depression and anxiety in people with terminal cancer, said Paul Hutson, the pharmacy professor who oversaw the research.
Hutson said he is seeking funding to do other studies involving people addicted to opioids or methamphetamine. Research has suggested that psilocybin may help people quit smoking or stop using cocaine, he said.
The Madison-based Usona Institute — founded by Bill Linton, founder and CEO of Fitchburg biotech company Promega — is planning a multi-site study of psilocybin for depression, with enrollment expected to begin by the middle of next year, according to Usona’s website.
Hutson said the pharmacy school might be one of the study sites. Usona funded his earlier psilocybin research.
The new MDMA study for PTSD, at 16 sites around the country, is sponsored by the Multidisciplinary Association for Psychedelic Studies in Santa Cruz, California. It is expected to enroll at least seven patients in Madison, in the same treatment room as where the psilocybin study was conducted.
MDMA “has the potential to allow participants to become more willing, open and curious about aspects of their trauma during the therapy sessions,” Christopher Nicholas, a UW clinical psychologist co-leading the study, said in a statement.
The drug “serves as a catalyst, allowing these processes to manifest in a more spontaneous and self-directed manner,” Nicholas said.