No not the cereal obviously which was named as part of a diet developed by Kellogg’s for those of you that did not know. What I am talking about the anesthetic Ketamine now being approved by the FDA to treat the depressive disorder.

It is best known to the public as a club drug.  For street drugs I use a source called erowid.org and here is what they say about ketamine.

The effects of sub-anesthetic doses of ketamine are generally reported to be pleasant, though if they are unexpectedly intense, they can be distressing. A well-known effect of ketamine at higher-range doses is the “K-hole,” where the user is removed from reality and set adrift in an introspective dream-like world, often involving complete dissociation, immersive visuals, and out-of-body experiences. At higher doses, the user can be incapacitated and unresponsive, or uncoordinated and erratic, appearing unwell to the uninitiated eye. Nausea and vomiting may also be present.

While ketamine is not known to be physically addictive, prolonged use could be tolerance-building as well as leading to psychological dependency.

So obviously being in the club in an alternative reality is a good thing.  Here is an experience excerpt:

It was like I was pushed back a bit out of reality, making everything feel distant and even slightly unreal, typical dissociation. Everything seemed to be in a different angle, including me. Also, a certain unique visual distortion was noted, some grain and especially in the dark things seem to pull/slide in certain directions while never actually truly leaving their place. I often also physically feel this pulling and sliding too, especially if dosage increases, eventually if the dosage is high enough, I will slide out of reality entirely, but this time the dose wasn’t high enough for that so I would just feel like I floated around a bit, feeling unattached from my body the world and even certain parts of the mind.”

So now the FDA has approved this for use in the treatment of depression.  While it has been used as an anesthetic in conscious sedation, it has not had other medical uses suggested until recently.  According to the New York Times:

The approval of esketamine marks a new approach to treating serious mood problems, experts said. Prozac and similar drugs enhance the activity of brain messengers such as serotonin; they are mildly effective, but they take weeks or months for their effects to be felt, and for many patients, they provide little or no relief from depression. In contrast, the ketamine-based compounds — several others are being developed — work within hours or days, and are effective in some people who are considered “treatment resistant,” meaning they have not benefited from other antidepressants.

It is very cost prohibitive, and while covered by insurance, the out of pocket expenses are insane I am sure. But Nursie poo, you said this had been around for years, why is it so expensive?  Well, simple, since it was approved for a new “on label use” when it is prescribed in that formulation it can be charged by the brand name cost (since it will only be in that bottle).  Do you want the simple?  They found a way to use it to make more money.  They can charge a major amount because they hold the formulation for the treatment of depression.  Nursie poo would love a dollar or two of this, but alas we don’t get this.

So, should I run out and ask my provider to give me this?  This depends on how resistant your depression is.  This is why you have conversations with your provider about your symptoms and have a responsible conversation with them. I know the horse is practically cremated by has much as it has been beaten.

From my standpoint, I have seen good and bad with this.  I have not had good experiences with it when used on me as an anesthetic. I was nauseous with a bad “hang-over.”  That doesn’t mean you shouldn’t try it if you and your prescriber feel it may be appropriate.  Sometimes with new things, we get so mired in “being depressed” that we make it how we are.  It is often easier to stay the way you are than allow this change to happen.  I found that I defined myself with PTSD not defined myself first with PTSD as a part of my make-up. Subtle change makes your treatment a hell of a lot more possible because you are admitting that you are you and this is part of you, but not all of you.

The same thing with medicine.  Sometimes we are so rooted in the things we take, that we balk when we are told to use a new medication. As a prescriber I try and keep an open mind with new medications and honestly, I have a ton of reading even though I will most likely never prescribe this because of my current position.

The bats are always happy especially when the rain stops.