Regardless of the etiology, depression is a disabling illness that makes one feel swallowed in a deep hole, and desperately in need of a rescue.
Unfortunately, in our culture, first and foremost, that rescue comes from the medical field. The focus is mostly on the brain and not as much on the soul. However, antidepressants, though helpful at times, have not been effective in a good number of cases. There are also a lot of valid questions in relation to the side effects of these drugs.
Recently, psychiatric literature has been buzzing with a new treatment using ketamine. This is a very controversial drug, with serious side effects, which enjoys claims of immediate efficacy for depression. I am referencing an article in this post that is supportive of ketamine, but ironically, comes across very troubling for any attentive reader. It promotes the benefits of Ketamine, presenting them with a shining light, but the truth can easily be found between the lines. Ketamine, is not currently FDA-approved to treat depression, but it is being prescribed off-label by many psychiatrists.
My hope is that, regardless of their desperation, people with depression would subscribe to ketamine treatment with open eyes and full knowledge of the benefits and the risks. I believe this is a useful article for those who might be considering ketamine as a potential treatment for depression. The following is an excerpt:
Modern psychiatry has made amazing developments in the treatment of mental illness with drug therapy. Just a short time ago, a patient whose depression was resistant to treatment through therapy and medication had the option to try electroconvulsive therapy or ECT. (Some patients were forcibly electroshocked without their consent, which is a whole other ball of wax). ECT is incredibly controversial and not for the faint of heart. Today there may be a new solution for patients who find that their depression does not respond to therapy or FDA-approved drug treatments.
This new solution is not quite as controversial as ECT but there are concerns about the use of this drug to treat depression. How worried should we be about introducing ketamine as a treatment for depression?
Ketamine is commonly used in veterinary medicine to tranquilize or euthanize animals and it is even used to tranquilize humans as well, typically for surgical procedures. It is also sometimes used as a date-rape drug and is probably best known by its nickname: “Special K.” Ketamine a psychedelic drug like LSD or mushrooms, which can cause hallucinations in addition to general euphoria. It’s typically found at raves and parties, but it does have several medical applications. While its medical use comes with few side effects, ketamine abuse can lead to amnesia, incontinence, and death. Unsurprisingly, it is also highly addictive.
As Dr. Matthew explains, ketamine works in hours, not weeks. For some patients, it could literally be life-saving. There is, however, a risk to the use of ketamine as a treatment. Like all medicines, there are potential side effects. In ketamine’s case, the main danger is the likelihood of addiction. That potential certainly does exist, much like opioid pain-killers have dramatically increased the number of people addicted to pain medication, often spurring them to try heroin as well.
Ketamine has been used as an anesthetic since the Vietnam War, but it can also cause hallucinations and lead to addiction. It was made a Schedule III substance in 1999, putting it on par with LSD in the eyes of the law. This is why many companies are seeking to create drugs that are similar to ketamine in their effect on depression but without the high. Both a nasal spray and a pill are being explored by two different companies as potential treatment options. These drugs are all still currently in the clinical trial phase, so it could be years before any of them are approved for depression treatment.
Ketamine already has an established track record in the medical community as a drug that can be used to stop physical suffering. It is actually the go-to drug in emergency rooms for children with serious pain. Ketamine can cause hallucinations and an “altered” sense of reality, even at the low doses that are used to treat adults with depression. But most of the negative consequences, such as hallucinations and addictive behavior, come from the drug being used in much higher doses and not under doctor supervision. The risk is still there but it has already been proven to be a risk that doctors are willing to take in other medical situations.
The problem with ketamine is much like the problem with opioid painkiller abuse. The opioid epidemic comes not from having and using opioids, when they are needed, but from not treating opioids in a way that acknowledges how dangerous they can be. It was caused by patients, doctors and drug companies that advertised, falsely, that the likelihood of addiction is low, pushing painkillers as the wave of the future. (If you’re interested in the institutional contribution to the rise of the opioid epidemic take some time to watch Frontline’s “Chasing Heroin”). But the lessons to be learned from the opioid epidemic are not to avoid new drugs that have addictive potential. Almost all powerful drugs have the potential for addiction and most medications have potential side effects. It’s a cautionary tale that speaks to the need to monitor treatment and remove financial incentives for over-prescribing and over-promoting new wonder drugs. We should approach the use of ketamine carefully, but not deny its potential usefulness because it can be abused.
In my view, it is irresponsible, in the absence of FDA approval, to even recommend ketamine as a viable treatment for depression. Our society has been suffering severely from the opioid epidemic and its disastrous consequences for so many families. When a favorable article, such as this, asserts that “Ketamine can cause hallucinations and an “altered” sense of reality, even at the low doses that are used to treat adults with depression,” and that it is “highly addictive,” I would seriously hesitate to recommend this as a treatment of choice for any of my loved ones!
Before we subscribe to such an invasive and controversial treatment, we should pause and remember that not all tragedies, sorrows and holes within our souls can be addressed by drugs.