This post was originally published on October 6, 2016.
Whether you call it Special K, Ketaject, Vitamin K or Super K, Ketmaine hydrochloride tugs you down the K-Hole into a dizzying state of euphoric disassociation and even hallucination. In fact, plenty of users have found their lives destroyed after getting addicted to this illicit street drug, which is currently only approved by the FDA for use as a cat tranquilizer. (I want to say something snarky and funny about cats, but I fear the backlash.)
Despite its known dangers, the Food and Drug Administration just decided to put a variant on ketamine called “esketamine” on a fast track for approval as a treatment for depression.
Break on Through to Happiness
Classifying the drug as a “Breakthrough Therapy Designation,” the FDA has gifted Janssen Pharmaceuticals—a company owned by Johnson & Johnson—with the promise of imminent profit. Janssen has engineered esketamine as a nasal spray to treat major depression and as a nearly-instant antidote to suicidality. Unlike Special K, esketamine doesn’t have the same kind of serious psychological—ahem—hallucinogenic side effects as the street drug. Or so we’re told.
Originally synthesized by Calvin Stevens in 1962, ketamine was used as a sedative and analgesic to treat members of the U.S. army in Vietnam, but once the government got word that it could make you hallucinate, its use was prohibited for humans—until a few weeks ago, that is.
The main reason ketamine got the emergency green light is that the drug has been shown to alleviate symptoms of depression almost immediately (what a shocker that a street drug could do that). Most antidepressants take a minimum of a few weeks to start changing brain chemistry enough for a sufferer to notice a difference (although in my case, I noticed a difference almost immediately, perhaps a sign that I need them that desperately). Often this means four to six weeks have to pass before the worst depression cases can even begin to function or feel that proverbial dark cloud lift. If someone is struggling with suicidal despair, that’s too long to wait. Studies have also shown that esketamine can alleviate depression symptoms for up to 30 days after a single dose.
So, Is This Like a Miracle Pill?
Perhaps it’s understandable, then, that researchers at Janssen Pharmaceuticals are screaming from the rooftops about their breakthrough drug. David Hough, lead researcher for eskatmine at Janssen and also a psychiatrist, is one such proponent.
“I was a practicing psychiatrist for many years and saw many patients. Over 41,000 people end up dying by suicide every year in the U.S.,” he told CNN. “It’s sort of an un-talked-about thing.” The number of annual suicides is greater than those who die from breast cancer every year, so if ketamine can help, it’s probably a good thing that the FDA stepped in and granted Janssen emergency approval to market the drug.
“It’s really groundbreaking,” Hough said.
Well, There Might Be a Catch
Despite its efficacy in dealing with extreme cases of depression, esketamine can also produce an array of unpleasant side effects. However, Hough still believes administration of the drug in a controlled clinical setting is worth the risk of potential adverse reactions. Prescriptions of the drug won’t be a thing, at least in the near future. Side effects include an increase in blood pressure, dizziness and other symptoms—so presently, patients who take the drug will have to camp out at the doc’s office for at least two hours for observation.
“We want to make sure patients are protected,” Hough said
Hough understands that the general public might have some hesitation about using any form of ketamine—even medically—given there’s a proven history of abuse of the drug. But he wants to make sure this concern doesn’t preclude the help it might bring to suicidal people. Still, look at where we got as a society with prescription painkillers—a terrible opiate crisis.
I think given ketamine’s potential for abuse, it is important to explore eskatamine with both eyes wide open. You do have to remember, too, that Hough is working for Janssen; the very company that stands to profit in billions from their intranasal esketamine concoction.
As someone who has suffered from both major depression and countless episodes of legit suicidality, I feel this fast-tracked approval might be a great thing. But every body and every mind is different and responds to these substances differently. Just remember to read all the fine print before you hit up your doc for the stuff.