. Beginning in the mid-2010s, more and more doctors started offering ketamine as a treatment for depression. In 2019, the Food and Drug Administration approvedas a treatment for forms of depression that haven’t improved with standard antidepressants . Given over ten years of experience with ketamine as a researcher and physician at the Yale School of Medicine, in this article I try to answer some basic questions prospective patients often have about ketamine/esketamine.
The published data and my clinical experience suggest that at the proper dose, the vast majority of patients are able to get through this experience without problems. Some people like this"dissociative" experience, other people dislike it but find it bearable, and for others it’s not pleasant or unpleasant. The important thing to remember, especially for those who do not like this feeling, is that it reliably goes away after about an hour.
It's also important for patients to understand that this"dissociative" experience is almost always most intense for the first treatment. Your brain and your mind seem to adjust quickly to the"dissociative" experience and, thus, the second and subsequent treatments are not as intense. Some patients worry that this is a problem and that the drug is not"working" as much as it did during the first treatment.
On rare occasions, a patient has an intensely unpleasant or anxious experience with ketamine. This experience may resemble a panic or anxiety attack. Sometimes patients later describe the sensation as if they were dying or already dead. Among those who use ketamine recreationally, this seems to be similar to what is sometimes called a"K-hole.
Chen G, Chen L, Zhang Y, Li X, Lane R, Lim P, Daly EJ, Furey ML, Fedgchin M, Popova V, Singh JB, Drevets WC. Int J Neuropsychopharmacol. 2022 Apr 19;25:269-279.is Associate Professor of Psychiatry at the Yale School of Medicine, where he also serves as Associate Director of the Yale Depression Research Program.Understanding what emotional intelligence looks like and the steps needed to improve it could light a path to a more emotionally adept world.