Clinical depression is a devastating disease that is made worse by the lack of effective treatment. Several drugs can treat the disease, but they take months to become effective, often cause side effects, and only work in a subset of the patient population. Treatment often begins with an extended period of trial and error, sometimes taking more than a year.
Ketamine provides a shortcut. The drug can often lift symptoms of depression in under 24 hours, and the effects persist for roughly a week after a single administration. So why isn’t everybody using it?
Tweaked formulations of ketamine would be a great thing. We use it routinely for procedural sedation and less frequently as an adjunctive analgesic, but I could see HNK having a valid ED role in psychiatric emergencies. If I had a patient with refractory depression, why not give them a single IV dose to relieve their symptoms while awaiting psychiatric evaluation? I give pain medication to people with appendicitis while awaiting surgical cure, and this seems analogous.
On an obscure webpage that looks like it’s been barely updated in the last decade there’s a link to download a PDF with the unassuming name of “NDSP Catalog.” Click it and you’ll find pretty much every drug you can dream up: meth, cocaine, heroin, MDMA—nearly 800 compounds in all. Welcome to the scientist’s stash of illegal drugs, available for free from the government.
The catalog, aka NIDA Drug Supply Program, provides scientists with scheduled substances for human and animal research. If you’ve ever seen a subway ad recruiting for marijuana research or a news coverage of how cocaine addles the brains of mice, then you’ve likely indirectly encountered the NDSP.