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Is it ethical to use ketamine to treat acute depression?




Ketamine has been used as an anesthetic for decades. It's also a widely popular but illegal club drug known as
Ketamine has been used as an anesthetic for decades. It's also a widely popular but illegal club drug known as "Special K."
Huw Golledge

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Ketamine, or “Special K,” as it’s referred to on the street, is a drug that’s been used since the 1960s as a painkiller and an anesthetic during surgery for humans and animals. But these days, psychiatrists and clinics are turning to it to treat the most extreme cases of depression -- for those with symptoms that don’t respond to any other treatment. Some sufferers that use ketamine report an almost immediate alleviation of symptoms that might have been plaguing them for decades. The kind of quick relief this offers to depression-stricken people seems positive.

But some docs criticize its use, saying that long-term effects are unknown and some psychiatrists and clinics don’t understand the drug well enough to administer it properly. But advocates say the drug is approved by the FDA as an anesthetic and it’s giving people in crippling emotional pain the help they need -- now. Critics have concerns about ketamine being addictive, since it’s an opiate. But supporters say, the dosage received by patients battling depression are in far lower dosages than what a drug addict, using “Special K,” might take-in. Supporters also say, pharmaceutical companies stand to gain if ketamine use is discouraged; the companies would then have the ability to capitalize on making a new drug. Ketamine is expensive though. Clinics might charge somewhere between $300 and over $1000 per treatment, and there’s no guarantee an insurance company will cover it.

What happens to patients who have positive reactions to the drug, but then can no longer afford it? For how long is depression alleviated? Is the drug addictive? Should there be more clinical trials to prove its safety and efficacy for depression related cases?

Guests:

Dennis Hartman, founder of the Ketamine Advocacy Network -- an informational site for those suffering from chronic and treatment-resistant depression. He had used ketamine for the last two years, and says it saved his life.          

Dr. David Feifel, MD, psychiatrist and professor in the Department of Psychiatry and Neurosciences Program at UC, San Diego

Dr. Alan Schatzberg, MD, psychiatrist and professor of psychiatry and behavioral sciences at Stanford University