There are private clinics popping up across the US, which are offering ketamine to patients. What sort of advice would you give to people and is it a wise choice or should they be guarded about this?  

Dr. Sanacora: It is a very difficult question to answer. As we know depression is in some cases an incredibly disabling and very severe for many people. When the classic treatments have not been effective, there is a real desire to go out and get whatever treatment may be beneficial. In that sense, I think ketamine does offer some hope, but what I really caution people about is, there are several very important questions that we still do not know about ketamine and probably the most important is what is the long term benefit? Is repeated dosing of this actually a good idea? Both in terms of efficacy, does it actually work when it is used repeatedly, but also in terms of safety? We really do not have all that much information on repeated dosing in patients with depression.

How important is this research overall in the field of depression? We hear about medical breakthroughs in other areas of medicine all the time, so is this really major stuff for this area of medicine?

Dr. Sanacora: At this point, I would say it has been one of the major new findings in the field for at least a few decades. For two reasons, one is it might actually offer a more direct immediate benefit to the patients, clinical benefit for the patients, but also in terms of the scientific knowledge that it is giving us.  It has really opened up a new vista or a whole new landscape of new targets and treatments that can be developed for the treatment of depression that is not specifically ketamine by itself.

I was going to say, because ketamine is really just the tip of the iceberg. 

Dr. Sanacora: I really think ketamine is the tip of the iceberg here.  It has opened our eyes to new avenues to pursue for the treatment of not only depression, but many other neuropsychiatric disorders. 




Madonna Fasula, A.P.R.N

Yale University School of Medicine