Ketamine is a synthetic anesthetic and a disassociative recreational drug used primarily in the medical community for the initiation, and maintenance, of anesthesia. The drug was first synthesized in 1962 by Calvin Stevens of Parke-Davis Laboratories and was intended to be used primarily as a veterinary anesthetic. In 1966 Parke-Davis patented Ketamine for use in humans and animals and by 1969 it was available by prescription under the brand name Ketalar. Following its FDA approval in 1970, Ketamine was used extensively in the Vietnam war and found itself right at home in the tool belts of many physicians across the world. However, it would not be for another 30 years that the anti-depressive actions of Ketamine would become realized and studied.
Ketamine's use for the treatment of depression has been toted as one of the most significant advancements in the field in the last 50 years and for good reason. Ketamine is wholly unique in its speed of anti-depressive effects, mechanisms of action, and safety. Patients suffering from suicidal ideation in conjunction with treatment-resistant depression may see an improvement in their symptoms within 4 hours of treatment. In 2019 the first Ketamine treatment for depression was FDA approved and began use under the brand name Spravato. Spravato is unique from Ketamine you would find in a hospital setting in that it is not a racemic mixture of both isomers of Ketamine, but rather a pure concentration of Esketamine molecules that usually only comprise 50% of racemic Ketamine. Johnson and Johnson, the developers of Spravato, chose Esketamine specifically for its higher affinity for the NMDA receptor in the brain, which is believed to be responsible for a large part of its antidepressant effect.
At Island Psychiatry we strive to offer the most advanced, evidence-backed treatments available to help our patients achieve their goals. Spravato, and by extension Ketamine, is at the forefront of this endeavor. By utilizing this medication we are pushing the boundaries of current mental health treatment and helping individuals who may have tried most classic treatments with no response. As the landscape of mental health treatment evolves, we at Island Psychiatry will continue to adopt novel, evidence based treatments in the pursuit of the well-being of our patients.