K powder is the new antidepressant, the new drug
For those familiar with ketamine, it is a component of anesthetics commonly used on the operating table, such as ketamine hydrochloride injection, and an addictive drug known as' K powder '. But last March, the FOOD and Drug Administration approved Spravato as a treatment for depression -- the first time in decades that the FDA has approved a new drug for depression. In August, the FDA gave a green light to use Spravato to treat suicidal thoughts and behaviors.
How did this chemical, discovered less than 60 years ago, go from hallucinogenic drug to "magic pill" for depression? Is the current ketamine therapy really worthy of patients' trust?
"K powder" past life
The compound, codenamed CI-581, was first synthesized in 1962 by Calvin Lee Stevens in a lab at Wayne State University. At the time, Stevens saw it only as a potential anesthetic. The compound is now known as ketamine.
In the 1960s, one of the motivations for ketamine and other anesthetics was to provide emergency medical care to soldiers on the battlefield.
In 1970, the FDA approved the routine use of ketamine, which for a long time became the most commonly used medical anesthetic in the United States.
Ketamine, however, was abused during the Anti-Cultural movement in the US in the 1970s.
The misuse of ketamine has led to serious consequences.
Because of the health risks, ketamine is strictly regulated in various countries. But in the lab, ketamine has been revived, even as a new hope for treating depression.
Unexpected depression medications
In a trial in the late 1990s, John Krystal of Yale University and his colleague Dennis Charney gave seven depressed patients a 0.5 mg/kg body weight dose (below the anesthetic mentioned above) of ketamine and a placebo. The next day, nearly all of the patients who received ketamine reported significant improvements in their depressive symptoms, while those in the placebo group reported no significant changes. With the work of Kristal et al on ketamine, our understanding of depression is finally gaining ground after decades of stagnation.
In 2018, A team led by Hu Hailan of Zhejiang University School of Medicine found that small doses of ketamine can also relieve depressive symptoms in other ways.
From experimental evidence, scientists are beginning to understand the mechanism by which ketamine provides rapid relief from depressive symptoms. Although there are still some unanswered questions about how this works, with the knowledge available, scientists can begin to design drugs.
The future of "magic medicine"
Depression is an extremely complex mental illness, so the development of drugs for depression cannot be smooth sailing.
Ketamine offers hope to many depressed patients, but its many side effects and lack of regulation make the notion of ketamine as the "magic drug" for depression deeply contradictory.
Ketamine is "not a pseudoscience that needs to be overturned," but "a drug that needs to be tightly controlled." While seeing the "one-hour cure for depression" myth, we must not ignore the problems of ketamine.
The future of "magic medicine" still needs to be cautious.