Posted by: Christopher Maloney, Naturopathic Doctor | January 30, 2012

Ketamine: Depression Cure, Better Than Morphine, or Dumb High?

Ketamine

Image by coda via Flickr

Wow, ketamine is in the news these days.

It’s being touted as a cure for depression.  And not just by the media.  We have several small studies being done on resistant major depression patients with good results.  But without a defined mechanism, the concept of a depression cure needs a bit more work.  Why?  Read on.

Another use for ketamine is combining it with opiods for pain reliefIn this it seems to help.  The combination is really a medical version of what “special K” was used on the street for in the 1990s: as a support for another drug to make its effect more powerful.

But what about the depressed folks?  Well, we don’t have a group of patients we can overdose on ketamine, but they did that to a bunch of monkeys (here’s the abstract).  The results were not pretty.  Ketamine in your brain blocks a receptor “triggering excessive glutamate release and subsequent cortical excitation which may induce psychosis-like behavior and cognitive anomalies. Growing evidence suggests that acute ketamine administration can provoke dose-dependent positive and negative schizophrenia-like symptoms.”  So our friends with the sudden improvement in depression may have just been going a different, and not-so-good direction.  But that’s just acute use.  Chronic use of ketamine generated “accompanied by diminished total movement compared with the controls. Importantly, the mesolimbic, mesocortical and entorhinal-striatal systems were found to be functionally vulnerable to ketamine’s chronic effects. Dysfunctions of these neural circuits have been implicated in several neuropsychiatric disorders including depression, schizophrenia and attention deficit disorder.”  Oops.  Maybe ketamine isn’t the miracle drug for depression we’d like it to be.

What about recreational use?  I cannot speak to this as elequently as this wonderful gentleman from Gawker who did a great deal of special K back in the day.  He says it’s the dumbest drug ever.


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