Ketamine Therapy Will Go Mainstream in 2022—for Better or Worse

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Ketamine Therapy Will Go Mainstream in 2022—for Better or Worse
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Just as rates of depression are on the rise, so is the scramble to find solutions that could help provide relief to millions of Americans. More doctors and patients are pinning their hopes on a relative newcomer to psychiatric treatment: ketamine therapy.

. That included 57 percent of adults aged 18–29.

Adam Kaplin, a neuropsychiatrist at Johns Hopkins University and the chief scientific officer of MyMD Pharmaceuticals, knows this research firsthand. He worked with drug company Janssen Pharmaceuticals to develop Spravato and he’s seen impressive results from supervised ketamine therapy. Access in 2022 might be fast and convenient, but it’s also unregulated. Bradley Kramer, a trained physician and lawyer who specializes in catastrophic medical liability at the firm Biklaw Trial Attorneys, likened the current ketamine therapy environment to “the wild, wild West.”Until recently , ketamine was only administered under very controlled conditions. Patients had to be deemed eligible—meaning they were diagnosed with a treatment-resistant form of depression.

Another option is for patients to simply go to a brick-and-mortar ketamine clinic that will prescribe the drug off-label and administer it intravenously under supervision—similar to a hospital visit, but at a site that’s dedicated to ketamine therapy. These are popping up more and more in urban areas over the last few years. The follow-up therapy sessions run with a mental health professional, however, may vary widely from clinic to clinic.

“For some people, the idea of not having connections to body and self is so disorienting that it becomes psychological trauma,” he said. “And that’s why you want to have somebody there, so when it becomes overwhelming, you have an anchor. In my role as a sitter, I’m part of the container. It’s not me doing the therapy with the person, I’m there so that as things get out of control, I can say, ‘OK, let’s return you to your breath.

That includes the speed at which ketamine enters the bloodstream. Lozenges dissolve slowly in the mouth over 20 minutes—Fergus described the taste as “crushed up aspirin and Drano”—so the odds of a patient trying to binge on them is probably low. While this can prevent an overdose or a misuse of the drug, it can also blunt how much relief a patient can get out of the drug.

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