Since the beginning of healthcare, doctors and researchers have been trying to improve patient care. Over the years, there has been significant growth in medication research, and one of the most prevalent psychiatric drugs that have come to be is Ketamine: used not only as an anesthetic but as a treatment for chronic pains.
The invention of Ketamine came to be in early 1950. Scientists were trying to find an alternative for general anesthetics, and the main focus was on PCP (Phencyclidine). PCP was discovered by Parke-Davis and Company’s laboratories in Detroit, Michigan, USA. It proved to be a very effective analgesic, but it came across many complications during the animal testing phase. Despite these complications, it went onto the market with a trading name of Sernyl. As expected, PCP caused multiple side effects that could be proven lethal such as poor muscle relaxation and dangerously low breathing rates. Due to these complications, PCP was taken down from the market, and the search for an alternative continued.
In the early 1960s, Scientist Calvin Stevens at Parke Davis Laboratories synthesized Ketamine by merging ketone with an amino; studying its chemical properties, it was clear that Ketamine could become a successful anesthetic. The research trial officially started in 1964, and patient trials revealed that Ketamine was not just an anesthetic but also a psychedelic: many patients claimed that when they were under ketamine influence, they felt they were in a dream-like stage and dissociated with reality. Despite this side effect, it was clear that Ketamine was an effective anesthetic, and for this reason, it was approved by the FDA to be used as an anesthetic.
Ketamine was most well known for the role it played in the Vietnam War. With thousands of soldiers wounded every day, surgery and on-site treatment had become crucial and, because it was considered a safe drug, it was often used as a rapid pain relief medication as an anesthetic.
In 1973 and 1985, 2 prominent studies were done to understand Ketamine as an anesthetic better. The studies noted that Ketamine had caused an antidepressant effect among patients, which lasted up to 2 weeks (Golechha, Rao, Raggu 1985; Khorramzadeh & Lofty 1973). When this was brought to light, the National Institute of Mental Health (NIMH) designed a study to understand this phenomenon (Zarate 2006). This study found that over 50% of patients who suffered from treatment-resistant depression felt significantly better; they also noticed many participants complaining about the psychedelic effect, also known as an “emergent syndrome,” and ran a trial to exclude or limit this effect. Through this trial, they came to a dosage of .5mg/kg over a span of 40 min, which resulted in less disassociated effects and effective antidepressant effects. In this trial, it was noted that a single ketamine infusion had a transitory impact on depression, meaning that single sessions weren’t enough to treat treatment resistant depression, and it could relapse. Another study was launched by the NIMH, which confirmed that Ketamine’s effect lasted the longest on the patient (zarate 2012). With heavy research supporting Ketamine’s impact on TRD, it became FDA approved in 2019 and used in many clinics to treat chronic conditions such as depression.
Usually, only ⅓ of patients respond to antidepressants (in which there are more than 25), while more than half respond to Ketamine (Fekadu 2009); considering these statistics: Ketamine is regarded as a success in the world of psychiatric medicine. Now: Ketamine is viewed as a therapy that provides immediate rapid relief of depressive symptoms and suicidal intent. It is the only legal psychedelic (class of hallucinogenic drugs whose primary effect is to trigger non-ordinary states of consciousness via serotonin 2A receptor agonist) medicine as a schedule 3 substance with an indication as a dissociative anesthetic, and it is used to treat many chronic conditions.
This concludes the brief history of how ketamine came to be. Although it was designed to act as only an anesthetic, over the last few years it has changed the lives of millions by freeing them of their pain.
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