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FDA Approves Ketamine for Treatment-Resistant Depression

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Last Updated on August 10, 2023

ketamine nasal spray

Yesterday, on March 5, 2019, the FDA approved the use of ketamine for treatment-resistant depression. The new drug Spravato is a nasal spray that will only be available at specialty pharmacies, clinics, and doctor’s offices. Patients are not allowed to take it home with them. Although access to Spravato is highly restricted and it can only be administered by a medical professional, there are still risks involved.

Ketamine, a commonly abused club drug, is praised by drug users for its euphoric effects and “out-of-body” experiences, yet condoned by others for its ability to be used as a date rape drug. It’s also touted by some medical professionals as a miracle drug and treatment for depression. So which is it? Dangerous club drug or miracle drug? Here’s what you need to know about ketamine.

What is Ketamine?

Ketamine is classified as a dissociative anesthetic, which is a drug that has the ability to distort sight and sound, inhibit physical movement, and produce “out-of-body” experiences. A popular club drug and party pill, many users refer to ketamine by its street names or slang terms, which include:

  • Special K
  • K
  • Cat valium
  • Cat tranquilizer
  • Jet K
  • Kit Kat
  • Purple
  • Special La Coke
  • Super acid
  • Vitamin K1

Aside from being a commonly abused club drug, ketamine does have legitimate medical uses. In fact, it is a well-established anesthetic drug that has been used to sedate people for medical procedures for the last 50 years or so.

Ketamine was used to treat wounded soldiers on the battlefield during the Vietnam war and it is still widely used by the U.S. military today, as it has been shown to reduce symptoms of PTSD among veterans.

In low doses, ketamine can relieve pain, depression, and reduce or even completely eliminate suicidal ideation very quickly. On the other hand, when it is abused, ketamine can cause hallucinations, increase heart rate and blood pressure, and potentially even cause fatal respiratory problems, among other harmful short-term and long-term side effects.

Is Ketamine Addictive?

Although it is effective in treating symptoms of deep depression and suicidal ideation, ketamine does have the potential to cause dependence and addiction, especially if it is used on a long-term basis.2 A person who has developed a ketamine addiction may lose interest in their hobbies, isolate themselves from others, experience cravings, and be intensely preoccupied with using ketamine.

Other physical signs of ketamine addiction and abuse may include:

  • Disorientation
  • Drowsiness
  • Difficulty concentrating
  • Fatigue
  • Lack of coordination or difficulty moving
  • Slurred speech
  • Skin redness
  • Insomnia
  • Bladder pain and/or incontinence

What are the Long-Term Effects of Ketamine?

Using ketamine on a long-term basis can result in several harmful side effects. In low doses, ketamine can help to relieve symptoms of severe depression, but when it is abused and taken in large and/or frequent doses, it can cause serious physical and psychological damage.

When people abuse ketamine to get high, they often describe it as “falling into a k hole.” This slang expression is used to describe the feelings of impairment and self-detachment they experience while they are high on the drug. Abusing ketamine can also result in euphoria, which may encourage a person to continue abusing it.

The risks of ketamine abuse are serious and include:

  • Abnormal heartbeat
  • Low blood pressure
  • Difficulty breathing
  • Seizures
  • Abnormal movements
  • Irreversible brain damage
  • Date rape3,4

There is very little research available regarding the long-term effects of ketamine, but one study found that chronic abuse of ketamine can cause verbal problems, short-term memory loss, and visual memory loss. It may also result in urinary problems and permanent brain damage.5

Who Abuses Ketamine?

Despite the unpleasant short-term and long-term side effects of ketamine, some people still abuse it due to the euphoric effects it provides and the “escape” from reality that a “k hole” experience offers.

Although many experiences using ketamine can definitely be unpleasant, at least 50 percent of ketamine users report experiencing pleasant effects like happiness, relaxation and an enhanced perception of the things around them.3 People who are struggling to cope with difficult life situations may also abuse ketamine regularly to escape the stress of everyday life, despite its negative effects.

Ketamine is classified by the FDA as a Schedule III drug and according to the National Survey on Drug Use and Health (NSDUH) young adults ages 18 and older are the most frequent abusers of ketamine and other hallucinogens like LSD, MDMA (Ecstasy), and NBOMe.6,7 Ketamine first emerged as a recreational drug in the mid-1980s and continues to be abused by young adults in the party scene. Since its effects are felt quickly and they generally wear off in an hour or less, it is ideal for recreational abuse at clubs and raves.

Ketamine Treatment for Depression

On March 5, 2019, the FDA approved the use of a ketamine nasal spray to be prescribed for treatment-resistant depression. The drug was evaluated based on five different clinical trials, but only two of the studies showed significant positive results compared to a placebo.8

The drug esketamine will be sold under the brand name Spravato and will only be administered in a certified medical office under the direct supervision of a medical professional. Patients cannot take the drug home with them.

According to recent reports of the FDA-approval of Spravato, this new drug will be beneficial for people who suffer from treatment-resistant depression, but that population is a small one. The majority of people will not benefit from the drug.

While some doctors are fully onboard with ketamine treatment for depression, others are not. Some medical professionals argue that although the risks of prescribing ketamine for depression are real, so are the risks of untreated severe depression.

Regardless of its potential for abuse and addiction, ketamine clinics exist nationwide., giving rise to the view that ketamine is an effective and safe treatment for severe depression and suicidal behaviors. Many of these clinics provide ketamine infusion therapy, which is a series of IV infusions administered over several days.9 This type of treatment has not been thoroughly tested for long-term safety and effectiveness but experts say, based on the positive studies we do have, it shows promise for treating deep depression.

Medical experts aren’t exactly sure how ketamine works to treat depression, but they do know that it works differently than other popular antidepressant drugs like Celexa, Zoloft, Prozac, and Cymbalta. According to a recent article from The Fix, Dr. Steven Mandel, president of the American Society of Ketamine Physicians, says ketamine treatment relieve his patients’ symptoms of depression 83 percent of the time and stops suicidal ideation more than 90 percent of the time.10

Risks of Using Ketamine to Treat Depression

When taking ketamine for any reason, whether recreational or medical, severe side effects may occur. Depending on the dosage taken, a user may:

  • Have a severe allergic reaction
  • Experience abnormal movements
  • Experience dissociation (feel disconnected from yourself and your body)
  • Have trouble talking
  • Have low blood pressure and an irregular heartbeat
  • Have difficulty breathing5

Although medical administration of the drug is safer than recreational ketamine abuse, it should still be used with caution and there is always a risk of dependence, abuse, and addiction.

Additionally, it’s important to recognize that ketamine is not a miracle drug and it won’t solve all your problems. Based on the research available, if you are suffering from severe depression and suicidal thoughts, ketamine infusion therapy or the recently-approved Spravato may temporarily help relieve the symptoms of depression and stop suicidal ideation, but ongoing therapy is necessary to address the root causes of the psychological problems.

Help for Ketamine Addiction

If you are suffering from ketamine addiction and depression, your substance abuse could be contributing to your mental health issues. If you need help to recover from addiction, drug detox and long-term rehab can provide comprehensive, ongoing care and behavioral therapy to eliminate drug-abusing behaviors and address the root causes of your addictive behaviors and co-occurring disorders like depression. Call Nova Recovery today to learn more about our 90-day drug rehab program and aftercare services.

References:

  1. https://drugfree.org/drug/ketamine/
  2. https://www.rxlist.com/ketamine-hydrochloride-side-effects-drug-center.htm#professional
  3. https://www.verywellmind.com/what-is-a-k-hole-21861
  4. https://drugfree.org/drug/ketamine/
  5. https://www.verywellmind.com/basic-facts-about-ketamine-67495
  6. https://www.dea.gov/drug-scheduling
  7. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf
  8. https://onezero.medium.com/the-party-drug-that-could-help-stop-depression-2e57c195b294
  9. https://www.thefix.com/club-drug-ketamine-nears-fda-approval-depression-treatment
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