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Alzheimer's, Dementia & Mental Health

Nasal Spray Delivers New Depression Treatment to Right Spot in Brain

20 million Americans, mostly women, suffer from depression

March 24, 2014 – A nose spray that uses new technology to deliver drugs directly to the brain is being hailed by researchers at Canada’s largest mental health and teaching hospital and the University of Toronto as a promising new way to treat depression.

The spray delivers a peptide (compound made of two or amino acids) to treat depression.

"This study marks the first time a peptide treatment has been delivered through nasal passageways to treat depression," says Dr. Fang Liu, Professor in the University of Toronto's Department of Psychiatry, who led the study with colleagues from the Centre for Addiction and Mental Health (CAMH).

The peptide treatment interferes with the binding of two dopamine receptors – the D1 and D2 receptor complex. Dr. Liu's team had found that this binding was higher in the brains of people with major depression. Disrupting the binding led to the anti-depressant effects.

The peptide is an entirely new approach to treating depression, which has previously relied on medications that primarily block serotonin or norepinephrine transporters.

About Depression (MedlinePlus) Depression is a serious medical illness that involves the brain. It's more than just a feeling of being "down in the dumps" or "blue" for a few days. If you are one of the more than 20 million people in the United States who have depression, the feelings do not go away. They persist and interfere with your everyday life. Symptoms can include - > Sadness > Loss of interest or pleasure in activities you used to enjoy > Change in weight > Difficulty sleeping or oversleeping > Energy loss > Feelings of worthlessness > Thoughts of death or suicide Depression is a disorder of the brain. There are a variety of causes, including genetic, environmental, psychological, and biochemical factors. Depression usually starts between the ages of 15 and 30, and is much more common in women. Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter. Depression is one part of bipolar disorder. There are effective treatments for depression, including antidepressants and talk therapy. Most people do best by using both. Women experience depression more often than men. Biological, life cycle, and hormonal factors that are unique to women may be linked to women's higher depression rate. Women with depression typically have symptoms of sadness, worthlessness, and guilt. Men with depression are more likely to be very tired, irritable, and sometimes even angry. They may lose interest in work or activities they once enjoyed, and have sleep problems. Older adults with depression may have less obvious symptoms, or they may be less likely to admit to feelings of sadness or grief. They also are more likely to have medical conditions like heart disease or stroke, which may cause or contribute to depression. Certain medications also can have side effects that contribute to depression. NIH: National Institute of Mental Health

Depression, the most common form of mental illness, is one of the leading causes of disability globally. More than 50 per cent of people living with depression do not respond to first-line medication treatment.

The technology for the nose-to-brain delivery was developed by the U.S. company Impel NeuroPharma. The company announced last March a successful trial with their Precision Olfactory Delivery (POD) technology that was seen as opening the door for central nervous system (CNS) drugs to be delivered directly to the human brain, allowing potential treatments for complex neurological conditions.

The study is published online in Neuropsychopharmacology.

In a previous study published in Nature Medicine in 2010, Dr. Liu developed a protein peptide that provided a highly targeted approach to treating depression that she hopes will have minimal side effects. The peptide was just as effective in relieving symptoms when compared to a conventional antidepressant in animal testing.

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However, the peptide had to be injected into the brain. Taken orally, it would not cross the blood-brain barrier in sufficient concentrations.

"Clinically, we needed to find a non-invasive, convenient method to deliver this peptide treatment," says Dr. Liu, Senior Scientist in the Campbell Family Mental Health Research Institute at CAMH. With the support of a Proof of Principle grant from the Canadian Institutes of Health Research (CIHR), Dr. Liu's team was able to further explore novel delivery methods.

The Impel NeuroPharma system was shown to deliver the peptide to the correct part of the brain. It also relieved depression-like symptoms in animals.

"This research brings us one step closer to clinical trials," says Dr. Liu. In ongoing lab research, her team is experimenting to determine if they can make the peptide break down more slowly, and travel more quickly in the brain, to improve its anti-depressant effects.

Notes:

The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital, and one of the world's leading research centers in its field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit http://www.camh.ca.

The Canadian Institutes of Health Research (CIHR) is the Government of Canada's health research investment agency.

 

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