Could a drug prevent depression and PTSD? | Rebecca Brachman

Summary

This script recounts the accidental discovery of antidepressants from tuberculosis treatments and their evolution to modern SSRIs. It highlights the limitations of current treatments and introduces 'paravaccines' like Calypsol, which may prevent stress-induced mood disorders. The talk suggests a paradigm shift from treating to preventing mental illnesses, proposing the potential of repurposing drugs like ketamine to enhance stress resilience.

Takeaways

• 🔬 In the late 1800s, tuberculosis was a leading cause of death, and its cause was unknown, with a romanticized perception in society.
• 🤔 The first antidepressant was discovered accidentally when the tuberculosis drug iproniazid led to patients becoming 'inappropriately happy'.
• 💡 The concept of accidental discovery in science is highlighted, emphasizing the importance of recognizing such opportunities for innovation.
• 🛑 The speaker shares personal experience with 'smart luck' in neuroscience, suggesting a combination of chance and preparedness leads to breakthroughs.
• 🌐 Mood disorders like depression and PTSD are compared to early 1900s infectious diseases, indicating a current epidemic in mental health.
• 🏥 The prevalence of mental illness in the U.S. is noted, with one in four adults affected, highlighting its widespread impact.
• 🚑 Depression is identified as the leading cause of disability worldwide, surpassing other major diseases like HIV/AIDS and diabetes.
• 🧬 The discovery of antidepressants like imipramine was also accidental, arising from drugs intended for other purposes, emphasizing the challenge of drug repurposing.
• 💊 The limitations of current antidepressants, including severe side effects and the lack of a cure, are discussed, pointing to the need for better treatments.
• 🧬 The role of serotonin in depression treatment is critiqued, suggesting that an overemphasis on it might have hindered progress in finding a cure.
• 🔑 The discovery of Calypsol (ketamine) as a rapid-acting antidepressant that works on glutamate, not serotonin, presents a new direction in treatment.
• 🛡️ The 'paravaccine' concept is introduced, with Calypsol showing potential to protect against stress and prevent mood disorders, offering a preventative approach to mental health.
• 🌐 The economic burden of mood disorders is highlighted, with costs projected to rise significantly in the coming years, underscoring the urgency for effective treatments.
• 🛂 The challenges of drug repurposing, including overcoming biases, navigating policy, and the lack of financial incentives for generic drugs, are discussed.
• 🌟 The potential of using drugs like ketamine as paravaccines to prevent mental illness is presented as a novel and promising approach in psychiatry.

Q & A

What was the common belief about tuberculosis in the late 1800s?

In the late 1800s, it was believed that tuberculosis, also known as consumption, was caused by one's constitution, and it was romanticized as a disease of poets, artists, and intellectuals, thought to confer heightened sensitivity and creative genius.

How did the understanding of tuberculosis change by the 1950s?

By the 1950s, it was understood that tuberculosis was caused by a highly contagious bacterial infection. This shift in understanding allowed for the development of drugs to treat the disease.

What was the accidental discovery that led to the first antidepressant?

The first antidepressant was discovered accidentally when doctors administered the tuberculosis drug iproniazid to patients. Instead of just treating TB, it also made patients more social and energetic, leading to the realization of its mood-enhancing effects.

What is 'smart luck' in the context of scientific discovery?

In the context of scientific discovery, 'smart luck' refers to the ability to recognize and capitalize on unexpected findings or accidents, turning them into significant advancements or discoveries.

How did the early antidepressants have in common the neurotransmitter serotonin?

Early antidepressants like iproniazid and imipramine both increased levels of serotonin, a neurotransmitter in the brain. This commonality led to the development of selective serotonin reuptake inhibitors (SSRIs), which specifically target serotonin.

What is the current state of treatment for mood disorders like depression and PTSD?

As of 2016, there are no known cures for mood disorders like depression and PTSD. The treatments available are drugs that suppress symptoms, similar to how painkillers work without treating the underlying infection.

What is the significance of the drug Calypsol in the treatment of mood disorders?

Calypsol, also known as ketamine, is significant because it acts on glutamate rather than serotonin and works quickly within hours or a day. It has been discovered to have antidepressant effects and potentially enhances resilience against stress-induced mood disorders.

What is the concept of 'paravaccines' in relation to mental health?

'Paravaccines' are a novel concept in psychiatry, referring to drugs that have the potential to protect against stress and prevent the development of mood disorders like depression and PTSD, similar to how vaccines protect against infections.

What challenges does the repurpose of drugs like Calypsol face in terms of policy and pharmaceutical development?

Repurposing drugs like Calypsol faces challenges due to a lack of incentives for pharmaceutical companies to develop generic, off-patent drugs, as well as the need to overcome functional fixedness and mental set biases in recognizing their potential new uses.

What is the potential impact of 'paravaccines' on the future of mental health treatment?

The potential impact of 'paravaccines' could be transformative, potentially preventing mental health disorders rather than just treating them, which could lead to a significant reduction in the global burden of mental illness and its associated costs.

Why is recognizing the effects of a drug like Calypsol challenging?

Recognizing the effects of a drug like Calypsol is challenging due to the lack of dramatic side effects like mania, which made the effects of early antidepressants more noticeable. Additionally, preconceived notions and biases can hinder the recognition of a drug's potential for new uses.