How Ready is the World for Ketamine Therapy?

How Ready is the World for Ketamine Therapy? - Moonhaus

A presentation was made in the Maryland Psychiatric Research Center by a psychiatrist, Salvador Roquet, in the fall of 1972. This presentation was worthy of note because the psychiatrist came from his home in Mexico City to make a presentation in an institution funded by the United States government. This presentation was about an ongoing study that Roquet led.

The study feature a group therapy session where his staff will administer morning glory seeds, psilocybin mushrooms, herb Datura and peyote cacti to a group of participants over eight hours or thereabout. Roquet will then provide what he referred to as a sensory overload show to push the participants through an extreme experience of psycho-spiritual rebirth.

The sensory overload show is orchestrated using lights, images, and sounds from erotic or violent movies. One of the participants in this study, an American professor of Psychology, referred to the experience as a descent into hell. However, in a bid to give the participants a smooth landing after the experience, he administers a common hospital anesthetic known as Ketamine Hydrochloride.

Roquet then observed that while the effects of other drugs are wearing off, the ketamine hydrochloride provided a lasting alleviation of the anxiety brought about by the disturbing sights participants faced during the study.

The observations from this study were novel to the researchers and clinicians at the Maryland Psychiatric Research Center. While they have been researching the effects of psychedelics such as LSD since the 1950s, the use of ketamine feels new. It was not discovered until 1962 some years before that presentation. A researcher, Calvin Stevens, working with a pharmaceutical company Parke-Davis synthesized ketamine while he was trying to get a less volatile alternative to Phencyclidine, PCP. Two years later in 1964, a doctor, Edward Domino carried how the first human trials of ketamine using men incarcerated in a Michigan state prison.

During the trials, he discovered that ketamine knocked people out when high doses are used while at lower doses, ketamine causes odd psychoactive effects in lucid patients. Given this effect, the pharmaceutical company wanted to avoid labeling the drug a psychedelic. Therefore, when Dr. Edward’s wife suggested that the drug be tagged as a dissociative anesthetic explaining the way it separates the body from the mind while allowing the mind to retain consciousness.

After a few years, the FDA approved ketamine as an anesthetic and the company started marketing it under the name Ketalar. It was widely adopted by the US Army during the Vietnam War and remains a standard anesthetic used in hospitals and emergency rooms around the world. However, Roquet found other uses for the ketamine substance. He also provided training for the clinicians at the research center.

However, when the presentation and training took place, there was already an ongoing war against psychedelics in the United States. In 1968, the US government criminalized the possession of LSD and President Richard Nixon announced a war on drugs three years later. Even Salvador Roquet was jailed in Mexico for several months and had to cut back on the group sessions he held. The research center also ended the research on psychedelics in the mid-1970s amidst the push back by the government.

However, the use of ketamine remained legal during this period. Also, clinicians at Yale discovered that ketamine can be used to improve people’s moods. This discovery was made during the study where ketamine was used to mimic the symptoms of schizophrenia. Also, researchers at the National Institute of Mental Health that have been studying the use of ketamine as a treatment option for depression found out in 2006 that a single intravenous dose of ketamine has rapid antidepressant functions.

After about three hundred clinical trials, the consensus by the experts is that ketamine provides relief for symptoms of depression that lasts for days and weeks. Many researchers have referred to ketamine as a “dirty drug” a term used to describe the fact that the drug works on different parts of the brain at the same time. By 2010, mental health experts were recommending the drug as an off-label treatment option for suicidal patients, and clinics that focus on ketamine treatment therapy started opening up around the country.

The growth and development in the use of ketamine for treatment are shown by the fact that the debate surrounding the use of ketamine has shifted from whether it works to discussions about how it works, the most effective delivery method, and the use of this drug may profit health care providers and drug companies.

New York Ketamine Infusions was one of the first clinics that specialized in the use of ketamine therapy in the treatment of depression and other mental health issues. It was opened in 2012 by Glen Brooks who was also an anesthesiologist trained at Harvard. He went into addiction medicine as a field came after one of his relatives suffered from an addiction problem. The former physician with about thirty years of experience practicing as a physician spent a few months studying addiction medicine and concluded that it was an exercise in futility especially when it comes to addressing the childhood traumas that made people engage in self-medication. However, his view changed when he read the early studies on ketamine and its use for treating mood disorders. Apart from a change of mind, he also saw a business opportunity.

In his clinic, he administers ketamine through intravenous means at a sub-anesthetic dosage and many of his patients have dissociative experiences after the treatment. However, in 2018, the use of psychedelics treatment for mental health issues became mainstream. Recently, Peter Thiel joined a group of investors to raise about 125 million dollars in funding for a biotech company that focuses on the use of psychedelics to treat mental health issues. In June 2021, the company, atai Life Sciences went public and was valued at about three billion dollars.

The popularity of the use of ketamine by people has been linked to its legality unlike other psychedelics such as mushrooms and LSD. This means that healthcare providers can administer it and companies can make money from it. An example is Spravato, a drug from Johnson & Johnson that the FDA approved in 2019. This drug uses one of the two molecules in the original ketamine compound. This means that the company can sell the drug at a more profitable price even if it is missing one of the important molecules that it needs to be effective.

As it stands today, you don’t need a doctor’s referral or prescription to get access to a wide array of treatment approaches with the drug. You also don’t need to be in severe pain and throes of mania or psychosis. All you need is a pocket full of cash, say some hundreds of dollars. You can easily get a titrated dose of the drug at a retail clinic operated by an anesthesiologist, a shot in the arm by a psychiatrist in private practice, or by a startup administering an oral lozenge advertised to people via email. If you get to certain cities with an adequate amount of money, you will get a mind-boggling trip at a clinic supervised by a therapist in a very legal setting.

While all of these seem interesting and good for the popularity of ketamine therapy, many countercultural therapists that have been using ketamine for a long time to treat mental issues find bemusement in the way ketamine is being used today. One of such therapists is Dr. Phil Wolfson who started using ketamine in 1990, has been administering it to his patients ever since, and has trained hundreds of therapists in the use of the drug. He prefers the administration of psychotherapy with guided trips and lozenges through intramuscular injections. He refuses to classify ketamine as an antidepressant because he believes that as much as diagnostic categories help to a point, they are also limiting.

He upholds the notion that ketamine’s particular power comes from its ability to give patients a subjective time-out. According to him, ketamine provides a brief period of void as against the visions that metamorphose into narratives produced by mushrooms and ayahuasca.

It is important to note that the most interesting results from the use of ketamine do not come from people with manageable anxiety but rather, people who suffer from treatment-resistant depression, chronic pain, and serious anxiety. An example of people like this is Zachary Rice who is a twenty-eight-year-old TV writer. He has been seeing a therapist since he was ten, and was diagnosed with clinical depression at 18. Other diagnoses came later in life as he was also said to suffer from acute PTSD and OCD. He has been using antidepressants since he was eighteen and has been prescribed about 13 different medications. He has also attempted suicide and during the pandemic, he started getting suicidal again. This was when he reached out to his therapist who gave him the option of using ketamine.  

Zachary Rice started the ketamine therapy and held about four sessions in ten days and has continued to happen every month. Like other patients, Rice has experienced positive changes in the state of his mental health after a few monthly sessions. However, you must know that ketamine is considered safe when used at intervals with a sufficient dose. However, being snorted or injected for long periods causes increased tolerance to the drug, cravings, kidney problems, withdrawal, and permanent urinary-tract damage.

For more details, you can check out Moonhaus or its collection of psychedelics to know more about ketamine and its use in the treatment of mental health.

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