Elon Musk’s Ketamine Endorsement Sparks Controversy

Elon Musk, the owner of X, recently revealed using small doses of ketamine “once every other week” to regulate the “chemical tides” underlying his depression. He believes it aids in breaking free from a “negative frame of mind.”

This has elicited various responses in the media, including on X (formerly Twitter), ranging from staunch support for Musk’s treatment choice to accusations of substance abuse.

But what precisely is ketamine, and what role does it play in depression treatment?

Its initial application was as a form of anesthesia.

Ketamine is a dissociative anesthetic employed in surgical procedures and for pain relief.

At specific doses, individuals remain awake but experience detachment from their bodies. This property is beneficial for paramedics, enabling them to communicate with injured patients while the drug alleviates pain without impacting breathing or blood flow.

Additionally, ketamine is utilized as a sedative for animals in veterinary medicine.

Ketamine consists of two molecules, commonly known as S-Ketamine and R-Ketamine.

S-Ketamine, or esketamine, is more potent than R-Ketamine and received approval in 2019 in the United States under the brand name Spravato for treating severe, long-standing depression unresponsive to at least two other treatment modalities.

Ketamine is believed to alter brain chemicals influencing mood. Though the precise mechanism of ketamine’s action on the brain remains uncertain, researchers speculate that it modulates the levels of the neurotransmitter glutamate, thereby impacting symptoms of depression.

What was the process of its development?

Chemists at the Parke Davis pharmaceutical company in Michigan, USA, synthesized ketamine initially, primarily as an anesthetic. In 1964, it underwent testing on a group of prisoners at Jackson Prison in Michigan, where it demonstrated rapid onset and minimal side effects.

Following this, the US Food and Drug Administration granted approval for ketamine as a general anesthetic in 1970. Following this, the World Health Organization incorporated it into the core list of essential medicines for healthcare systems globally.

In 1994, after patients reported improved depression symptoms post-surgery involving ketamine anesthesia, researchers commenced investigations into the effects of low ketamine doses on depression.

Researchers published the initial clinical trial findings in 2000, administering either intravenous ketamine or a saline solution over two days to seven participants. Similar to prior case studies, ketamine exhibited rapid alleviation of depression symptoms, often within hours, with effects lasting up to seven days.

In the last two decades, researchers extensively studied ketamine’s effects on various conditions like treatment-resistant depression, bipolar disorder, PTSD, OCD, eating disorders, and substance use, showing mainly positive results.

A study at a community clinic providing intravenous ketamine therapy found that most patients reported improved depression symptoms eight weeks into treatment.

Despite researchers’ efforts, ketamine studies over the past thirty years have remained limited, with only 22 studies involving 2,336 patients worldwide, in contrast to 1,489 studies on cancer drugs conducted in 2021 alone.

Is ketamine prescribed in Australia?

Despite its promising efficacy, ketamine’s exact mechanism remains unclear, limiting its availability through GPs for standard depression treatment in Australia. Instead, specialized clinics and research centers predominantly utilize it.

But its clinical use is expanding. In 2021, the Australian Therapeutic Goods Administration approved the Spravato nasal spray, usually administered under healthcare professional supervision, often by psychiatrists.

Unauthorized Use Concerns

The widespread reporting of fatalities associated with ketamine has heightened apprehensions about its misuse.

Since the 1970s, recreational users have described sensations of euphoria, trance-like states, and dreaminess induced by ketamine. However, recreational doses typically exceed those prescribed for depression treatment.

Limited data on ketamine-related deaths often links them to accidents or ketamine combined with other substances. Notably, no deaths have occurred during treatment.

Stigma Reduction

Depression ranks as the third leading cause of global disability, underscoring the need for effective treatments.

Seeking medical advice for depression treatment is preferable to following Musk’s recommendations on medication usage.

Nevertheless, Musk’s public disclosure of his mental health struggles and treatment experiences holds promise in reducing the stigma surrounding depression and promoting help-seeking for mental health issues.

Read the original article on: Science Alert

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