I know it would be impossible for them psychiatrists to prescribe ketamine for people suffering from depression. But I would like to see ketamine used in the hospital wards for people suffering from depression and anxiety. I can't see that coming. So we get nothing from magical antidepressant qualities of ketamine. Just like marihuana, it's the public enemy number 1 in my country after one party stated they would try to depenalize at least possessing amounts for one's own use (too bad they don't mention how many diseases can be cured or helped in some way with it, they don't quote any scientific journals - that would help a lot of people against it understand it's actually them who is wrong about marihuana; and they're wrong about most psychoactive substances). Another promising antidepressant (or rather its derivatives) is buprenorphine, it worked wonderful for me, it lifted my mood during the period I used it and it was something totally unlike dirty feeling one gets from SSRIs.
Big pharmaceutical companies won't let this all happen because they make too much money off SSRIs, SNRIs, etc. which simply just pretend to help, then you start feeling like a crap so some non-working anti-anxiety medication is added to the treatment. Eventually you're tapered off one shitty (S)(D)(N)RI to be transferred to another shitty one. This generates so much money because these drugs are expensive. In reality even when you compare the synthesis of ketamine or Bentley compounds with the syntheses of any of these novel (S)(D)(N)RIs, you see it costs less to synthesize the former. Buprenorphine synthesis - no refined substrates.
I am really sorry but if such bills like SOPA and ACTA are passed in the U.S. just like that, in the 21st century, then I don't believe ANY substance being a real real antidepressant will ever enter the market.
Really, if it's anybody's fault that ketamine isn't used in medicine as an antidepressant, it's not black market's fault or some "RC vendors' " selling various arylcyclohexylamines.
I am quoting this post from way back in the 3rd page and I've not read the later pages of this thread so I'm unsure Anyone responded to this point but I wanted to address this as while I understand your skepticism, I am very happy to report to that you are quite wrong on this point.
I'm not sure if you live in the US and are commenting on the US medical system/pharma industry, but I am a 2nd year resident in psychiatry and you will be surprised and happy to hear that ketamine and it's derivatives are very actively being not only researched, but actively used in a variety of clinical settings to treat refractory major depression. The hospital where I am doing my residency treats several patients a week who suffer from depression refractory to conventional treatment with ketamine infusions with great success. And while this practice is not yet mainstream, my hospital is certainly not the only medical facility that is using ketamine for this purpose.
Additionally Johnson and Johnson is seeking approval and patent for their "version" of ketamine in the form of a nasal spray indicated for treatment of depression. Now of course ketamine is an ancient drug and therefore J&J cannot make any money with ketamine in its current form...but they aren't letting a little problem like that stand in their way of turning a nifty product- they have simply separated the racemic mixture of ketamine and are patenting the isolated S enantiomer of ketamine and giving it the incredibly unimaginative name, Esketamine (get it.... S-ketamine).
And this is not some Hail Mary that won't make it to market for another decade if ever, all indications are this nasal spray form of ketamine will likely be available for psychiatrist like me to prescribe within the next year, 2 at the latest.
Another positive that will result from J&J's introducing Esketamine to the market as a treatment for depression, is not to be outdone, several of the other big pharmas are already developing their own NMDA antagonists similar to ketamine to get some of this newly formed market share.
Now the one thing you may not like about all of this, but I actually agree with, is these new drugs like the nasal spray Esketamine will almost certainly not be available for guys like me to just write a script for it which would allow u to run down to cvs and pick up your own personal bottle of nasal spray ketamine. It looks like these drugs will only be made available for inpatient usage, and again, as libertarian as I am, I still think it's a good idea to keep it relegated to supervised, impatient usage.
My reasoning for this position is this- patients w major depression respond dramatically, and almost instantly to these ketamine infusions (for many pts this remission only lasts a few days, but it is a profound response). As you could imagine, sending a pt who suffers from major depression home with a big bottle of ketamine and telling him to only use it X number of times per week or month is just not gonna work. We have developed treatment protocols/dosage scheduling which have proven to be effective, while minimizing the abuse potential.
It would simply be too much to expect of a pt with major depression to say, "here's a giant bottle of ketamine, now I know it relievs your depression almost instantly, but only use it every other day for the first 2 weeks, then once a week for the next month, the. Twice a month for the next 3 months etc". Take a depressed pt and send him home w a bottle of an abusable druf that provides instant relief and there's just no way he could stick to the treatment schedule.
