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We Are Team-Oriented In Caring For Psychiatric Patients

A team of researchers at Yale School of Medicine, in affiliation with YNHPH, is pushing the scientific envelope in exploring a novel, fast-acting treatment for depression.

Depression is a serious medical illness that afflicts more than 19 million Americans. Beyond simply a feeling of sadness or a case of "the blues," depression is a debilitating disorder that involves the brain but impacts the entire body. It affects everything from mood and thoughts to appetite and sleep, often for weeks at a time. The successful diagnosis and treatment of depression, in it various forms, has long been a hallmark of Yale-New Haven Psychiatric Hospital. Yet a team of researchers at Yale School of Medicine, in affiliation with YNHPH, is pushing the scientific envelope in exploring a novel, fast-acting treatment for depression.

Taking a Neuroscience Approach

John Krystal, MD, is chief of psychiatry; and since joining the faculty of Yale School of Medicine in 1988, he has become increasingly involved in neuroscience research, in particular studying how certain chemicals in the brain influence such disorders as schizophrenia and depression. What's emerging is the possibility of providing fundamentally new approaches to psychiatric treatment for the first time since the 1950s, when antidepressants, antipsychotics and other current medications were developed. "It's taken that long for us to understand how brain circuits work, to the point where this knowledge might relate to treatment," Dr. Krystal says.

New Use for an Old Drug

Ketamine is an anesthetic medication, discovered in the mid-1960s, commonly used today in surgery. In the late 1980s, Dr. Krystal and other researchers began examining ketamine's wider chemical interactions within the brain. Intrigued by what he learned, more recently Dr. Krystal's team at Yale-New Haven tested a variation of ketamine on a group of people suffering from depression. "Within 24 hours, nearly 40% of the patients with very severe symptoms experienced a significant improvement," he reports. By stark comparison, conventional drugs can take three to four weeks to begin producing similar outcomes. "This finding has tremendous potential value for treating the most acute and urgently ill patients with depression." The results have been replicated elsewhere, and the drug is receiving further intensive testing.

Creating Exciting Opportunities

"The qualities that typify our hospital's mental-health practitioners in psychiatry, psychology and social work — empathy, relating to people, treating the needs of individual patients — are not going away," Dr. Krystal asserts. "But now we're building on that tradition and bringing to bear opportunities to help people in new ways."

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