Ketamine as an Antidepressant

Ketamine as an Antidepressant

3 years ago

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.

Turbulent times lead to strong emotions
Turbulent times lead to strong emotions
2 years ago

It's okay to feel anxious, sad and restless these days! It might point you to some corners of your mind and psyche that need working on. If you are a human anywhere on this planet you feel the unse...

The Reluctant Psychiatrist
The Reluctant Psychiatrist
3 years ago

When I was a resident physician in training, I remember my excitement in mastering the principles of psychopharmacology. I was so eager to diagnose patients" problems and apply the right treatment....

What to do with a family member with a personality disorder
What to do with a family member with a personality disorder
1 week ago

Dealing with a family member who has a personality disorder can be challenging and emotionally taxing. It's important to understand that personality disorders are complex me...