The Pros and Cons of Ketamine as Medicine

The story of ketamine starts almost 60 years ago. That’s when an American research scientist, intent on coming up with a new anesthetic with pain relieving properties, formulated it. The year was 1962; the place was the Parke Davis Laboratories. Although first patented in Belgium, ketamine for medical use received approval from the U.S. Food and Drug Administration (FDA) in 1970. It didn’t take long for it to find its way onto the battlefield to treat U.S. soldiers fighting in the Vietnam War. As an anesthetic, ketamine got high grades. But “high” denotes another side of this substance.

Those in the illicit drug space gravitated to ketamine for its hallucinogenic qualities. Known on the street as “Special K,” it caused an out-of-body experience; it was also used as a “date-rape” drug. The recreational use of ketamine didn’t go unnoticed by authorities. In 1999, it joined the list of Schedule III non-narcotic controlled substances.

It’s been a mixed bag for ketamine. At the present time, there are accepted medical uses for it. Those include short-term sedation and anesthesia. And there are new applications as well. Ketamine is approved for use as medicine in the treatment of certain mental illnesses. Let’s review recent information.

Ketamine Roars Back in Medical Circles

The medical community and illicit drug trade paused using ketamine in view of its legal status. However, scientists still maintained interest in it. In the early 2000’s, some launched studies on this substance. Could ketamine prove to be of value in other applications in human medicine? Early findings showed that, at low doses, it had potential in managing chronic pain and treating depression. Ketamine was on the comeback trail.

The year 2019 proved pivotal for the resurgence of ketamine. Although work had been going on behind the scenes for some time, several announcements took place then.

One emanated from Florida State University about a potential breakthrough. A team based in the lab there had been working with ketamine for three years. Findings of these neuroscientists suggest it may limit the desire to drink alcohol. Experimenting with lab rats, the team discovered that ketamine curbed alcohol use by 70 to 80 percent. These positive effects lasted for three weeks after treatment ended. The leader of the study group addressed the timeframe issue. “Three weeks is a long time in a rat’s life,” he noted. “If a similar thing happened in humans, one could imagine that after a short treatment with ketamine, alcoholic patients would cease alcohol intake for a couple of years. That would be a great achievement.” These results are preliminary, but nonetheless major, if follow-up work confirms that point.

Hype in the Psychiatric Space

The big and definitive news about ketamine concerns mental health care. The headline of a post from Yale Medicine summarizes it: “How New Ketamine Drug Helps with Depression.” According to this piece, on March 5, 2019, the FDA gave the green light to “the first truly new medication for major depression in decades.” This drug comes in the form of a nasal spray based on esketamine, a derivative of ketamine. Since this new offering proves effective in “treatment-resistant depression,” the FDA fast tracked the approval process to make it available sooner.

How momentous is this innovation? The chief psychiatrist at Yale Medicine uses a term to describe the significance of this antidepressant based on ketamine. He calls it “a game changer.” That’s because it works in a different way from other drugs used for depression. He explains that: “When you take ketamine, it triggers reactions in your cortex that enable brain connections to regrow. It’s the reaction to ketamine, not the presence of ketamine in the body that constitutes its effects.” This product is helping to battle a debilitating mental health condition. The Yale article underscores the role of “Ketamine – from anesthetic to depression ‘miracle drug.’”

Hope and Hiccups with Ketamine as Medicine 

Ketamine has had a sketchy history and that persists. Despite the hoopla about its benefits in treating depression, this substance has a downside. The Director of the National Institute of Mental Health outlines it in his message announcing esketamine. “Many patients experience uncomfortable dissociative symptoms, hypertension, or other side effects for a few hours after administration. Because of these symptoms, as well as the potential for abuse, both (ketamine and esketamine) need to be administered in a doctor’s office.” Work is underway on finding solutions. He also alludes to the long-term effects. Is this product safe over time? Can it be used on an emergency basis and in that setting?

We’re back to where we began with another issue raised in the message above. Ketamine is an additive substance. That doesn’t go away no matter how it may be used. With regard to ketamine as medicine, both the pros and cons require close consideration. After all, if you find yourself compulsively using ketamine, or find yourself unable to stop using ketamine, it’s important to remember that there is help out there. Addiction treatment can help you curb compulsive ketamine use.