An increasing number of celebrities have been speaking out about their mental health struggles and the treatments they use to manage them. X owner Elon Musk recently shared his experience with using ketamine to cope with his depression. He mentioned that he uses small amounts of ketamine “once every other week” to manage his “chemical tides” and escape a negative mindset. This revelation has sparked a variety of reactions in the media, with some showing support for Musk’s treatment choice, while others raise concerns about his potential drug use. But what exactly is ketamine and how does it play a role in treating depression?

Ketamine is a dissociative anesthetic commonly used in surgery and for pain relief. At certain doses, individuals remain awake but disconnected from their bodies. This feature is particularly useful for paramedics, as they can communicate with injured patients while blocking pain without affecting breathing or blood flow. Ketamine is also utilized in veterinary practice to sedate animals. There are two molecules in ketamine – S-Ketamine (esketamine) and R-Ketamine, with S-Ketamine being stronger and approved in 2019 in the US under the brand name Spravato for severe, long-term depression unresponsive to other treatments. Ketamine is believed to alter brain chemicals that influence mood.

Ketamine was first developed as an anesthetic by chemists at the Parke Davis pharmaceutical company, tested on prisoners in Michigan in 1964, and approved by the FDA in 1970. It is now listed as an essential medicine by the World Health Organization. Research on ketamine’s effect on depression began in 1994 when patients reported improved mood after surgeries involving ketamine. Clinical trials have shown that ketamine can rapidly reduce depression symptoms, lasting for up to seven days, with positive results in various mental health conditions. However, despite promising studies and increased clinical application, the exact mechanism of ketamine’s action remains unknown.

Ketamine is mainly administered in specialized clinics and research centers due to the limited research and understanding of its long-term effects. In Australia, Spravato nasal spray was approved in 2021 for use under the supervision of healthcare professionals, with a high cost that limits accessibility. GPs can prescribe ketamine “off-label,” but caution is advised due to potential side effects and risks. Ketamine misuse has been linked to recreational drug use, causing concerns about its safety. Deaths related to ketamine are often associated with accidents or drug combinations, rather than its therapeutic use.

Effective treatments for depression are crucial, as it is a leading cause of disability worldwide. While Musk’s openness about his mental health struggles may reduce stigma and encourage seeking help, it is essential to consult healthcare professionals for appropriate treatment options. The increasing interest in ketamine therapy warrants further research to understand its effectiveness and safety. The controversy surrounding ketamine highlights the complexity of mental health treatment and the need for evidence-based approaches.

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