Anesthetic drug propofol shows promise in the treatment of medication-resistant depression

A commonly used anesthetic drug could help people with severe depression. Preliminary research published in the International Journal of Neuropsychopharmacology suggests that propofol may trigger rapid, durable antidepressant effects.

“Severe depression strikes millions of people each year, and up to one-third of these individuals do not respond to currently available treatments (medications, psychotherapy, brain stimulation),” said Brian James Mickey of the University of Utah, the corresponding author of the study.

“Intriguingly, some general anesthetic drugs (ketamine, for example) appear to trigger long-lasting changes in brain function. We hypothesized that brief exposures to the general anesthetic propofol might induce therapeutic neural changes in individuals with treatment-resistant depression.”

In the study, 10 patients with medication-resistant depression received ten rounds of treatment with high-dose propofol.

During the treatments, the patients were kept in deep sedation for 10 to 17.5 minutes. They remained unconscious for another 20 to 47 minutes after propofol was discontinued, but typically met discharge criteria 10 minutes after opening their eyes. No serious adverse events occurred.

“In our open-label (unblinded) trial, we administered propofol to 10 patients with severe treatment-resistant depression who were candidates for electroconvulsive therapy (ECT). Propofol treatment led to clinically significant and lasting improvement in depressive symptoms in 6 of 10 patients, similar to the response to ECT, but without ECT’s side effects,” Mickey explained.

The drug could become a viable treatment for depression, but more research is needed.

“Our initial study suggests, but does not prove, that propofol has robust antidepressant effects,” Mickey told PsyPost. “A blinded trial including an inactive (placebo) intervention is necessary to determine whether the improvement we saw is specific to propofol. It also remains unclear how propofol might work.”

“One of the participants in our initial study has written a memoir, which will be published later this year,” Mickey noted.

The study, “Propofol for Treatment-Resistant Depression: A Pilot Study“, was authored by Brian J. Mickey, , Andrea T. White, Anna M. Arp, Kolby Leonardi,Marina M. Torres, Adam L. Larson, David H. Odell, Sara A. Whittingham, Michael M. Beck, Jacob E. Jessop, Derek J. Sakata, Lowry A. Bushnell, Matthew D. Pierson, Daniela Solzbacher, E. Jeremy Kendrick, Howard R. Weeks III, Alan R. Light, Kathleen C. Light, and Scott C. Tadler.