Ketamine: Promising Path, False Prophecy, or Producer of Psychosis?

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In the journal Neuropsychopharmacology, Yale University School of Medicine’s Gerard Sanacora and Stanford University School of Medicine’s Alan Schatzberg examine the scientific literature on ketamine, and discuss some of the promises and dangers surrounding the recent resurgence of interest in the drug as a potential treatment for depression.

“There are a number of troubling findings regarding ketamine’s pharmacology that should be given a thought,” the authors write. “First, the drug does produce dissociation and psychosis and is subject to abuse.”

The January 2015 issue of Neuropsychopharmacology includes two other freely accessible articles on the same topic.

(Full text) Ketamine: Promising Path or False Prophecy in the Development of Novel Therapeutics for Mood Disorders? (Sanacora, Gerard and Schatzberg, Alan. Neuropsychopharmacology. January 2015. doi:10.1038/npp.2014.261)

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4 COMMENTS

  1. “… The drug does cause disassociation and psychosis …” so it’ll be another iatrogenic pathway drug to the “serious mental illnesses.” Same old psychiatric philosophy, it’s all about creating life long customers with terrifying and iatrogenicly induced illnesses.

  2. For what it’s worth, a single “trip” on this drug (well known both as a psychedelic plaything and a “twilight anesthetic” for minor medical procedures) strikes me as a safe bet. If someone gets temporary relief from this experience — and can use the experience to interrupt a crisis and start climbing off the floor — more power to them. That’s how ketamine was being used in the initial reports that sparked all this “possible breakthrough” chatter.

    Maybe these are the real reasons Dr. Alan Schatzberg (former prez of APA, who almost never met a drug he didn’t like) is issuing dire warnings about this one:

    First, ketamine has been off-patent for decades, so it’s hard for drug cos to make a profit on.

    Second, given that each dose will mean a trip to the clinic and being “out of it” for a day or so, it’s hard to find cost-effective ways to put patients on Maintenance Ketamine for Life.

    Most of the “mainstream” research & commentary I have seen focuses on solving these two alleged problems, i.e., finding a way to convert ketamine into a maintenance medication. A scary thing, because it’s chronic use that is most likely to damage patients’ brains. Much as a single good stiff drink to calm your nerves after a frightening experience may be fine … but Maintenance Bourbon Therapy for Generalized Anxiety Disorder would be a disaster.

    Thank heavens Dr. Schatzberg and his corporate sponsors can’t get a patent on booze!

    • Johanna, you’re spot on with this ketamine issue. What you wrote in this first chapter is pretty much what I also think:

      “For what it’s worth, a single “trip” on this drug (well known both as a psychedelic plaything and a “twilight anesthetic” for minor medical procedures) strikes me as a safe bet. If someone gets temporary relief from this experience — and can use the experience to interrupt a crisis and start climbing off the floor — more power to them. That’s how ketamine was being used in the initial reports that sparked all this “possible breakthrough” chatter.”

      Thanks for it!