Key points
Matthew Perry’s death is a symbol of what can go wrong with unregulated ketamine.
Market pressures are leading to sketchy practices to sell more and more ketamine to consumers.
At-home daily ketamine and injectable at-home ketamine may be unsafe.
Ketamine is an incredible molecule, capable of alleviating treatment-resistant depression as well as facilitating psychological breakthroughs. However, due to a lack of regulation and capitalist pressures to sell large amounts of ketamine, a wild and unruly West has emerged.
As an owner of a ketamine clinic, I see firsthand how difficult it is for patients to navigate this Wild West of ketamine. Patients researching ketamine hear diverse recommendations for best practices of ketamine treatments. Dosing protocols vary from clinic to clinic, ranging from four to 12 intravenous (IV) ketamine treatments. Some clinics maintain the same dose throughout the induction period, whereas others increase the dose. Booster recommendations vary from two weeks to six months to unnecessary. And then there are multiple routes of administration, like sublingual and intramuscular ketamine. More and more, clinics are recommending combining ketamine with talk therapy in a variety of forms, but some clinics do not. In addition, some clinics are run by behavioral health experts, while others do not have any employees trained in mental health, even though they are treating depression, posttraumatic stress disorder ( PTSD ), bipolar disorder , anxiety , obsessive-complusive disorder ( OCD ), and sometimes addiction . Company Profits
Perhaps the most concerning part of the Wild West of ketamine is the pressure on companies to prescribe more and more ketamine to increase profits. Some telehealth companies mail patients large quantities of ketamine for at-home use. Because generic ketamine is an off-label treatment for mental health disorders, it is not subject to U.S. Food and Drug Administration (FDA) regulations. Without regulations, the pressure to increase profits may lead to sketchy business practices, such as advertising ketamine to everyone and not just patients who need it. In addition, the risks of ketamine are downplayed, and the end goal seems to be selling large quantities of ketamine. I’ve seen some questionable […]
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