Ketamine, the dissociative anesthetic oft associated with rave culture, has recently piqued the interest of the scientific and medical community. Small studies have pointed to the drug’s allegedly incredible effectiveness as an antidepressant, but comprehensive medical research is still needed to produce definitive conclusions.
What we can say with certainty is that ketamine research is ramping up—and the results are promising. A number of new studies have explored using ketamine for treating devastating migraines, obsessive-compulsive disorder and even PTSD.
A new study, published last month in the American Journal of Psychiatry, looked at single ketamine doses and their effect on suicidal thoughts. The researchers, some from Yale but also from schools in Beijing and Czech Republic, conducted a systematic review and meta-analysis, which means they looked at a lot of previously published studies (ten, in fact), examined the patient data used and drew their own conclusions.
This was the first meta-analysis of this kind to look specifically at patients with suicidal urges. Of the 298 patients who participated in ten ketamine trials, 167 patients met criteria for baseline suicidal ideation.
“Using self-report outcome measures, ketamine similarly reduced suicidal ideation significantly more rapidly than was observed with the control treatments, with significant benefits noted at each individual time point,” the researchers wrote, adding, “We found that across 10 controlled trials, a single ketamine infusion rapidly reduced the severity of suicidal thinking, within 24 hours in more than half the patients, and with benefits observed up to 1 week.”
Of course, future studies need to look at the effect on suicidal ideation after a week, as “the possibility of rebound suicidal ideation remains.” Plus, the researchers recommend a more diverse pool of patients, instead of just those with treatment-resistant mental illnesses. Nearly 300 patients may sound like a lot, but in the medical research world, this is still a relatively small sample size.
What this study didn’t examine is how ketamine works in the brain, or as the researchers put it, “the specificity of this effect requires further exploration.”
Nonetheless, this research is exciting, not only because of how fast ketamine seems to be helping, but also because it encourages us to reexamine the role psychedelics play in addressing mental health issues.
Ketamine, a drug related to phencyclidine (PCP) that has been used in medicine since the ‘70s, can cause disassociation by blocking the conscious mind from communicating with other areas of the brain. In high doses, this can lead to feelings of out-of-body experiences, as well as time dilation and disorientation, sometimes known as a ‘K-hole.’ (In the majority of off-label therapeutic applications of ketamine, high doses are not used, and in fact, “antidepressant benefit of ketamine is not dependent upon having a hallucinatory experience,” according to a study in Neural Regeneration Research.)
For some people, these feelings are uncomfortable. But for many, they are what helps them face their depression and overcome it. In other words, it could be that hallucinations are a feature, not a bug.
That research from the American Journal of Psychiatry builds upon another large-scale study that was published in May. This one, published in Scientific Reports, looked at more than 41,000 patient files who had been given ketamine for pain and cross-examined their reported depression symptoms.
What they found may not shock you: “patients who received ketamine had significantly lower frequency of reports of depression than patients who took any other combination of drugs for pain.” In fact, depression symptoms dropped by 50 percent.
Of course, there are limitations to this study as well. The researchers didn’t have access to complete sets of medical records and the information was voluntary. “However,” the researchers wrote, “the combined set of records had provided sufficient statistical power for the analysis.” It was really a way of working backward to get a good population-sized study.
Researchers are already trying to discover related drugs that may work like ketamine. If 2017 provided such detailed, promising research for ketamine, imagine what next year or even the next decade will bring. Clearly, more funding for psychedelic studies should be a priority—and we really shouldn’t fear drugs that have visions as a side effect.