Comeback For Ketamine?

By Hank Campbell — Feb 03, 2016
Ketamine, a dangerous 1960s hallucinogenic, may have new life for treating major depression.
Credit: Shutterstock

Ketamine, one of the poster children of non-selective psychotropic (mind-altering) drugs, has been used in a mind-boggling number ways since its discovery in 1963: a general anesthetic, a date rape drug, a sedative, an analgesic (painkiller), a hallucinogen, and most commonly now, for animal surgery.(1) It was originally a "safer" alternative to phencyclidine (PCP), an intravenous surgical anesthetic in the 1950s that became famous later for causing crazy attacks by naked people on the stuff.

Whenever a drug elicits so many different psychotropic responses, as ketamine does, it automatically raises all kinds of warning flags. And it should, because this is almost certainly an indication that the drug binds to multiple receptors in the central nervous system a property that is almost always undesirable. Ketamine does just that.

Prior to GHB and Rohypnol, ketamine was arguably the most popular "date rape" drug because by the time you tasted its bitterness in a drink you were on your way to being unconscious. Because of its ability to cause hallucinations and potential for fatality, it fell out of favor as a legitimate therapy for humans yet recent papers, including dose-effect and infusion-time studies, found that ketamine has shown some impressive results as an treatment for major depressive disorder, mostly because of its fast-acting nature (2). A systematic review last year (n = 437 receiving ketamine, 21 papers) found that it produced an effect in a time period ranging from 4 hours to 7 days. Proponents claim it is 75 percent effective.

It couldn't come at a better time. Psychiatry has run out of gas in trying to help depressed patients for whom nothing has worked, L. Alison McInnes, a San Francisco psychiatrist, told the Washington Post.

Johnson & Johnson subsidiary Janssen Pharmaceuticals is now studying a ketamine derivative nasal spray in Phase III clinical trials. The World Health Organization Expert Committee on Drug Dependence has recommended that ketamine not be placed under international control.

The American Council has discussed its potential efficacy in depression for years. The need for a better approach for the treatment for major depression is acute. The answer may lie in a 53-year old drug for cats.


(1) Why use it in pets if it can kill humans? Despite what activists touting International Agency for Research on Cancer (IARC) claims about various chemicals choose to believe, pets and humans are not the same, and some things that may be more likely to harm a dog or cat may not be as risky for a human, and vice-versa. Chocolate is the perfect example. Much of the illegal ketamine on the street has been obtained from veterinary offices.

(2) Even the best SSRI antidepressants can take weeks, or even months to start working. And, different patients react very differently to different antidepressants. What works for one person may be a completely failure for another. It typically takes 2-3 tries to find the best drug for a depressed patient, meaning that months can go by where the patient is receiving no effective treatment.

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