Hopes have been high for some time, and a new review now seems to confirm them: The use of the anesthetic ketamine in mentally ill people can reduce depression and suicidal thoughts. This is what researchers working with Zach Walsh from the University of British Columbia report British Journal of Psychiatry Open. All available, high-quality studies were analyzed for this review. According to this, the symptoms decreased within a few hours in both severe depression and bipolar depression. This effect lasts for an average of three days, and at most even a week. The authors of the study emphasize: The amount of evidence for the therapeutic effects of ketamine is growing. Even with addictions, ketamine is said to reduce cravings in the short term and alleviate withdrawal symptoms. Ketamine works differently than the classic antidepressants. It works directly on the brain’s most important excitatory messenger system, not on the neurotransmitter receptors for, for example, serotonin – that could explain its rapid effect.
So far, the substance has mainly been used as an anesthetic for horses
But there are also doubts: Isabella Heuser, for example, director of the Charité Clinic for Psychiatry and Psychotherapy, is skeptical of the results. She warns against falling back on the ancient notion of so-called unit psychosis, according to which different mental illnesses can all be combated with the same means. “Personally, and in my clinical experience, ketamine is far from the sweeping ‘wonder drug’ that it was initially hyped.”
So far, ketamine has mainly been used in veterinary medicine; it is mainly known as an anesthetic for horses. During the Vietnam War, ketamine was used to treat combat injuries to soldiers. The anesthetic is also misused as a narcotic drug, it promises freedom from pain and sleep. Its effect on depression has been researched for two decades. However, the drug has not yet arrived in therapeutic practice in Germany.
The current review comprised 33 systematic reviews, 29 randomized control trials and 21 observational studies. The participants were aware that they were taking ketamine, which does not rule out a placebo effect. For some mental illnesses, such as anxiety disorders and PTSD, there is still little evidence of ketamine as a cure, according to the review. It is also unclear how ketamine therapy and psychotherapy can be combined.