Ketamine as an Antidepressant

Ketamine as an Antidepressant

The FDA's approval of esketamine (which is a derivative of the anesthetic drug ketamine) for treatment of depression has been hailed as a ‘game changer’ in the treatment of major depressive disorders. The exact mechanism of action of this drug still remains mostly unknown. There has been a rush of theories mostly focused on the neurotransmitter glutamate. As a psychiatrist who has practiced and followed the research over the last three decades, I am unconvinced by this explanation and its reductionistic, pseudoscientific description.

Let’s face it: This is an anesthetic and a club drug with side effects which include detachment, depersonalization and cardiovascular problems. The mechanism of action seems to be more related to possible anesthetic affects on the opioid system of the brain and the experiential effect of being detached from one’s reality. I am happy that we have more options to alleviate the pain and suffering of depression, but a rush to conclusions on the causes of depression seems premature.

Moreover I’m extremely concerned that there are clinics popping up everywhere not staffed by properly trained physicians in psychiatric medicine. If you are seeking this type of treatment I urge you to seek out an established medical center supervised by a board-certified psychiatrist experienced in all aspects of psychiatric care, not just the infusion or administration of ketamine products.

1 year ago
2 weeks ago

Are you tired of reading self-help books about anxiety management that do not help? Have you been in therapy for years without any sustainable benefits? Are you afraid of dependence on psychiatric...

1 year ago

Recently a patient whom I had not seen for almost a year showed up in my office demanding that her antidepressant prescriptions be filled for another year. She made it clear that she had no interes...

1 year ago

One of the more challenging aspects of my my work as a psychiatrist is when patients with good intentions come in to the office with a self-diagnosis of ADHD.  They are completely convinced af...

1 year ago

Low frustration tolerance is a hallmark of the ADHD sufferers. The scenario goes something like this: You are trying to focus on completing your expense report, and the guy from the next cubicle in...

1 year ago

You have been working hard all week and really look forward to going out with your fiancé to a nice restaurant and enjoying yourself. She has not seen you all week and is excited about findi...

2 weeks ago

By the time we are adults the condition we call ADHD in children morphs into a particular style of living and relating that the term itself does not imply at all. What was formerly a childhood lack...