Ketamine, once most famous as a “club” drug, can rapidly improve hard-to-treat depression and curb suicidal thoughts, a new review confirms.
In recent years, ketamine has emerged as something of a wonder drug for some people who do not get better with standard antidepressants.
For those patients, who may have tried multiple conventional medications, ketamine can quickly ease depression symptoms — even within a day. Experts say that speedy response is especially critical for people at risk of self-harm.
The new review, published recently in the British Journal of Psychiatry Open, pulls together all published research on ketamine as a treatment for psychiatric disorders. And it found that for treatment-resistant depression and suicidal thoughts, the drug can have quick, “robust” effects — albeit short-lived.
How does ketamine as a treatment for depression work?
“It is important to emphasize the drug doesn’t work for everyone,” senior researcher Celia Morgan, a professor at the University of Exeter in England says.
Nor is ketamine simple to take. It has to be given under medical supervision, Morgan notes, so doctors can watch for “dissociative” effects — or what lay people might call a “trip.”
The drug is not psychedelic, but typically triggers altered perceptions of reality, such as hallucinations, soon after it’s given. It can also cause a short-term spike in blood pressure, Morgan says.
So before anyone tries ketamine for depression, they have to get a full medical and psychiatric evaluation to make sure it is appropriate for them.
Ketamine was first approved in the United States decades ago as an anesthesia drug. Because of its mind-altering effects, it also came to be abused as a party drug, known by such nicknames as “special K.”
But researchers have long been aware of the drug’s potential, at low doses under well-controlled conditions, to treat psychiatric symptoms. Ketamine is not approved by the U.S. Food and Drug Administration for treating depression. But doctors can and do prescribe it “off label” for that reason.
The FDA approved ketamine derivative
And in 2019, the FDA approved a ketamine derivative — called esketamine (Spravato) — for depression that has not