Ketamine is an anaesthetic that has been used for decades in operating rooms around the world. As a therapeutic, it provides patients with what’s been described as a “mental time out” from distressing thought and behavioural patterns. This respite is thought to allow the brain a chance to establish new and more positive neural pathways while alleviating suffering in patients.
Although the drug has not received widespread approval by the US Food & Drug Administration for the express treatment of mood disorders, physicians are permitted to prescribe the drug “off label” at their own discretion. In 2019, esketamine – a version ketamine – was approved in nasal spray form for the treatment of major depression and suicidal ideation.
Yale University psychiatrists and researchers have called it a “miracle” drug and “game changer”, noting that in one study 70% of patients who were administered the nasal spray and had otherwise been unreceptive to treatment experienced improvement.
The flexibility in access has resulted in a boom of ketamine clinics, while President Trump-era legislation that permitted online prescriptions to flourish as a way for the country to grapple with the pandemic-related mental health crisis has resulted in the proliferation of use. The number of prescriptions issued in the US doubled between 2016 and 2021. Once known culturally in the US as party drug, a surge in online popularity of #ketaminetherapy on the social media platform TikTok reflects the extent to which ketamine is undergoing a mainstream cultural transformation.
While interest grows, some critics raise alarm over the lack of clinical oversight and the risk of misuse. The drug remains understudied and side effects are only beginning to be understood. Meanwhile, a recent proposal by US President Joseph Biden to overhaul the availability of prescription drugs online could lead to stricter controls on access.
On this episode of The Stream, we’ll speak with a panel of experts at the forefront of ketamine treatment to discuss the promises, realities and unknowns of this increasingly popular therapeutic.