Colloquially known as Special K, ketamine is an animal tranquilizer that has been a recreational substance since the ‘80s, and even still is somewhat rampant at parties and nightclubs. Before that, the drug was utilized during the Vietnam War as a therapeutic instrument on the battlefield for medics on the front lines.
The new medical incarnation: esketamine is a nasal-spray with the active ingredient of — you guessed it — ketamine.
Esketamine recently passed a phase-two clinical trial with flying colors, demonstrating its therapeutic uses for suicidal depression. The effects of esketamine occur in just four hours after treatment — an unheard-of length of time compared to conventional antidepressants such as Prozac and Paxil, which can take weeks to become effective.
A study published this past June in the American Journal of Psychiatry examined 68 patients receiving esketamine or placebos twice a week for four weeks.
The study concluded that esketamine “may result in significantly rapid improvement in depressive symptoms,” including suicidal ideation, for depressed patients at risk of ending their lives.
After taking an assessment called the Montgomery-Asberg Depression Rating Scale, the patients’ depression scores were significantly lower among the esketamine group.
Carla Canuso, one of the study’s lead researchers, called the results “robustly significant,” according to the Washington Post. Canuso works for the Johnson & Johnson subsidiary Janssen Pharmaceuticals.
She continued: “I think we‘re in a new generation of antidepressant drug development. It’s given us the opportunity to look at biochemical pathways that might be important in depression.”
But there is concern that the drug may be misused in the same way that opioids are.
“We felt it was a problem that really needed particular attention [because] it at least has the potential for causing similar problems to the opioids,” Robert Freedman, editor of the journal, told the Washington Post. “That was our single overriding concern.”
Another study published this weekcompared ketamine to a drug called midazolam, which is often used for anesthesia, and concluded that ketamine was superior to midazolam in decreasing depression.
If administered only during inpatient hospital stays, I believe ketamine could be a wonder drug, based on my knowledge from these studies and other research I have done.
However, given the dangers of misuse, I think it should not be made available as a drug easily picked up at the pharmacy, even as a controlled substance like benzodiazepines. It should not be a maintenance drug like traditional antidepressants. If that were the case, we could have a ketamine epidemic on our hands.
