Ketamine, while it is a useful sedative and anesthetic when used by healthcare professionals, is also known as a dangerous, illegal party drug. It can cause a trance state and hallucinations when used illegally as a recreational drug.
But in several clinics in the United States, ketamine is being used to treat depression in people who have not been helped by other treatments. It has also been used on an emergency basis to treat patients who are suicidal.
Ketamine appears to work by blocking receptors in the brain for a chemical called N-methyl-D-aspartate (NMDA). Some studies have shown that intravenous infusions of ketamine have a rapid effect on depression in patients who have not responded to other antidepressant drugs or other therapies. Patients show improvement within a few hours of a ketamine treatment, where other antidepressant drugs may take a few weeks or longer to work. This rapid action is why it has been used to treat suicidal patients in emergency rooms.
At ketamine clinics--many of which are run by anesthesiologists rather than mental health professionals--patients receive several intravenous infusion of the drug over the course of several days. Patients must be driven home after each treatment and are strongly advised not to drive or operate machinery for 24 hours after a treatment.
Although many patients respond well to the therapy, ketamine is not a miracle cure for depression. Patients still need to address other issues in their lives that have a bearing on their mental health.
The U.S. Food and Drug Administration has not approved ketamine as a treatment for depression. The drug's long-term safety and effectiveness as a treatment for depression has not been studied. Despite this, any physician can prescribe an approved drug for what are called off-label uses. Because of this, clinics around the country are using ketamine to treat seriously depressed patients.
Because it is not approved for use in depression, many health insurance companies will not pay for ketamine treatments.