An article titled "Ketamine: Studies Show Benefit" shares that the psychotropic benefits of ketamine, particularly its positive impact on depression, have been substantiated in various studies, providing hope for individuals grappling with mental health challenges and their healthcare providers. However, a disconcerting trend has emerged, spotlighted in a recent Wall Street Journal article, where online companies profit from selling ketamine tablets and lozenges for unsupervised home use. As of January 2023, the FDA has not approved any ketamine modality for psychiatric conditions, except for esketamine, a chemically similar variant, sanctioned specifically for depression and suicidality.
Expressing concern as members of the psychiatric community, this article emphasizes the hazards associated with unsupervised ketamine use. The FDA's approval of esketamine for depression comes with strict monitoring requirements in clinical settings due to potential distressing psychomimetic and cardio-stimulating effects. Mandated safety measures include monitoring vital signs, mental status, and post-administration state, coupled with the necessity for a designated driver to prevent vehicle operation under medication influence. Allowing patients to self-administer ketamine without supervision poses serious risks, including hypertensive crises, falls, accidents, and misinterpretations in dissociative states, potentially leading to harm or death.
Additionally, the article underscores the drawbacks of oral ketamine, citing its lower bioavailability compared to intravenous ketamine and esketamine, raising concerns about efficacy and safety. Limited data on oral ketamine's pharmacokinetic properties and its unexplored safety profile for depression treatment further highlight the need for caution. While ketamine holds promise as a mental health treatment, the article advocates for evidence-based practices and discourages online access without proper medical supervision until further research can determine the risk-to-benefit ratio of oral ketamine administration.
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