Any man could, if he were so inclined, be the sculptor of his own brain.
— Santiago Ramon y Cajal
What is Ketamine?
Ketamine and Esketamine are schedule 3 dissociative psychedelics aka hallucinogens, which have rapid-onset (within 1 – 2 days) efficacy in Treatment-Resistant Depression (TRD). The strongest evidence of efficacy is for intranasal esketamine and intravenous ketamine. There is insufficient evidence for oral, subcutaneous, or intramuscular ketamine for TRD, according to new international guidance on ketamine/esketamine. Intranasal esketamine demonstrates efficacy, safety, and tolerability for up to 1 year in adults with TRD. Evidence for long-term efficacy, safety, and tolerability of intravenous ketamine for patients with TRD is insufficient, the group notes.
Ketamine has been in use for many decades, often referred as a “dissociative anesthesia”. Ketamine is an NMDA-antagonist, but has many targets (opioid, GABA, D2, 5-HT, ACh, SNDRI, etc). It has a duration of action of 1 – 4 hours after each use.
Esketamine (Spravato) is FDA-approved for treatment-resistant depression (TRD).