So what happens when medical science studies and gets a complete understanding of illegal drugs? You get an advancement in the understanding of how to properly use illegal drugs for treatment. In Manhattan, there is a clinic that treats severely depressed and suicidal patients with a 45-minute intravenous infusion of ketamine which is also known as the illicit party drug Special K. The clinic is run by an anesthesiologist.Here is the kicker, patients don’t need a prescription, but not just anyone can get an appointment. This isn’t an underground drug lab but rather a well studied treatment center.
For ketamine to work, there needs to be some pre-existing brain damage caused by post-traumatic stress or event. There has to be a cause and effect relationship whereby it begins with overt pain, then fear, anxiety, loneliness, low self-esteem—or bullying, real or perceived. Treatment is performed by infusions with a low dose of the drug, about one-tenth of what recreational abusers of ketamine take. The infusions performed on patients are gradual but can experience sensations, such as seeing colors and patterns when they close their eyes or an overwhelming sense of positiveness.
The people getting the ketamine infusions are not drug addicts, abusers or people looking for a high. These patients are older patients are older and people who suffer post-traumatic stress become overachievers. These people become very successful, rise very quickly, and then crash. Some of the patients are artists, writers, actors, musicians, and painters.
Ketamine was first developed in 1962 as a fast-acting anesthetic. It’s still used widely in operating rooms and for pain management. Then it became popular as a recreational drug, due to its out-of-body, near-death experiences. In 1999 the U.S. Drug Enforcement Administration restricted nonmedical uses for ketamine, meaning that it has moderate to low potential for physical or psychological dependence. Studies have also shown that ketamine has the ability to be a mood stabilizer. The U.S. Food and Drug Administration hasn’t approved it for the treatment of mood disorders but rather the treatment is performed by off-label use.
An important statistic is that as many as 30 percent of depressed patients don’t respond to conventional antidepressants, according to the National Institute of Mental Health. Initial studies were often ignored or discredited due to the reputation of ketamine as a party drug. But as more small studies were performed, they showed that ketamine produced long-lasting changes in the brain, reversing neural damage caused by stress and depression and potentially decreasing inflammation and cortisol levels. This was performed after one or two infusions.
Pharmaceutical companies are invested in standard antidepressants such as Prozac and Wellbutrin which take weeks or months to kick in. To get FDA approval of ketamine for depression, multiphase clinical studies need to be performed and paid by big pharma. But these companies can’t make money off a decades-old generic drug. Instead, companies are developing similar, patentable drugs. Janssen is seeking approval for a nasal spray made from esketamine, a variation of the ketamine molecule. Cerecor, based in Baltimore, is developing a pill that replicates ketamine’s effects. Pharmaceutical giant Allergan acquired Naurex, whose main products are two clinical-stage ketamine-like drugs called rapastinel and NRX-1074. Both are designed to work like ketamine, alleviating depression without inducing hallucination.
Pharmaceutical companies tend to categorize the dissociative effect of ketamine as an unwanted side effect.But if you understand how ketamine works, you have to understand that the dream-like experience relies on hallucinations to perform the proper effect. The key to this is the dosage. As long as the dosage is low, the hallucinations are harmless and create a good mood. If the dosage is too strong or the infusion is too fast then you get the side effects of addiction and not a good feeling overall.
For most people, ketamine does not induce happiness so don’t expect to wake up tomorrow expecting to be cured with angels blowing trumpets. Instead of euphoria, patients tend to experience a lifting of their depressive symptoms and a gradual improvement with each successive dose. They report having an easier time with basic tasks like getting out of bed, brushing their teeth, or taking a shower. Some continue taking other mood stabilizers.
Do you think controlled ketamine infusions should be the preferred treatment for certain cases of depression?