Treating Depression with Ketamine

Small studies at prestigious medical centers like Yale, Mount Sinai and the National Institute of Mental Health suggest that a drug called ketamine can relieve depression in many people not helped by widely used conventional antidepressants like Prozac or Lexapro. At this time, there is little support for this treatment model, but future studies results will answer many questions about the efficacy and safety of this drug for depression treatment.

A club drug, ketamine has been used for decades as an anesthetic. Some psychiatrists are alarmed that clinics are springing up to offer ketamine treatments, charging hundreds of dollars for sessions that are repeated many times. Because ketamine has long been approved for anesthesia, doctors are allowed to use it off-label, and some are using it to treat depression.

The drug has not been studied thoroughly with regard to its use as a depression treatment and is wrongly being dispensed to desperate patients. Dr. Anthony J. Rothschild, a professor of psychiatry at the University of Massachusetts Medical School claims:

We don’t know what the long-term side effects of this are.”

One known side effect is described as feeling out-of-body experiences. Besides the psychotic like effects, ketamine can raise blood pressure and heart rate. Evidence from people who abuse the drug indicates that it can cause a decline in brain function and create bladder problems. So little documentation through clinical trials has been completed, that treatment with the lack of evidence is a very serious concern.

Critics say that some clinics are run by anesthesiologists who are familiar with ketamine but do not provide overall psychiatric treatment. Psychiatrists who might not have experience administering the drug run other clinics. Both scenarios use the vulnerability of patients who may feel desperate and be incapable of adequately weighing the risks of experimental treatments. Beware of therapy claims without the evidence.

Several large pharmaceutical companies hope to develop drugs that work like ketamine, but without the side effects. However, achieving safety and efficacy for this type of drug can be challenging, and some attempts have already failed. It will take time and many trials before any new drugs are developed.

A common refrain among ketamine advocates is that questions about its safety are emanating from drug companies, which have no financial incentive to develop ketamine. The drug is generic, inexpensive and therefore of little importance to companies where one drug competes or threatens the profits of another drug. Ketamine itself is ready for trials that may show it to be an inexpensive and effective form of short-term treatment for depression. These trials should be funded and pursued.

Eventually, science will tell us more about the risks and benefits of ketamine. It is best to consider other evidence-based treatments available until then.



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