Ketamine, a drug first used in the 1960s as an anesthetic for animals and people, is suddenly popping up across the United States as a treatment for depression despite the fact that the Food and Drug Administration has not approved it for that purpose.
The American Society for Ketamine Physicians, representing about 140 U.S. doctors, nurses, psychologists, and others who offer ketamine treatment, formed last year. Just three years ago, only about 20 ketamine clinics existed in the United States. That number has jumped to 150, according to society co-founder Megan Oxley.
While some praise the drug as a lifesaver for the 100 million people worldwide who don’t respond to conventional depression treatment, others warn too little research exists to know if it’s a safe antidepressant. Researchers have conducted only a few very small trials and only in a laboratory setting.
Exactly how ketamine works remains unclear, but it appears to affect a different brain pathway than traditional treatments. Commonly used antidepressants can take weeks to become effective, a dangerous delay for suicidal patients. And even then, conventional medications do not help up to 30 percent of the people who take them. Ketamine, on the other hand, works within hours and often benefits people who do not respond to FDA-approved drugs. But ketamine offers short-term benefits only: A single IV dose can provide relief of depressive symptoms within four hours, but the effects only last about a week. Possible side effects include rapid heart rate, increased blood pressure, and hallucinations.
Scientists at the Stanford University School of Medicine recently discovered that ketamine appears to activate the brain’s opioid system, a fact that has some concerned ketamine could turn into the next wave in the opioid abuse crisis. Already, abuse of ketamine is booming, particularly among the nightclub and party crowd, and it is well-known as a date-rape drug.
Ketamine clinics often promise unproven benefits, Stat Medicine reported. Some don’t thoroughly screen patients, and experts worry they’re offering the drug to anyone who can afford it. Clinics can charge anywhere from $350 to close to $1,000 per infusion, and many patients get at least six rounds of the treatment. Patients are “getting treatments they may not need or that don’t work, or they’re getting more than they needed,” Jeffrey Lieberman, chief psychiatrist of Columbia University Medical Center, told Stat. Doses and frequency of treatment vary widely among clinics, and the ketamine providers often don’t coordinate care with a patient’s mental health provider.
But warning and risks aside, many patients clamor for the drug. Actify Neurotherapies, a ketamine infusion provider that oversees 10 ketamine clinics, said it has received nearly 28,000 inquiries just since January.