The death of the beloved star of the “Friends” series, Matthew Perry, was a shock to his fans around the world, especially since he seemed to be on the road to recovery from the addiction that had haunted him most of his life. However, the report that revealed that the cause of death was “ketamine” shed light on this. The drug, and the controversy surrounding its use.
Ketamine was a drug intended for medical and veterinary anesthesia, before it became a popular and fast-acting treatment for depression and other serious mental health conditions, according to a report published by the newspaper “Washington Post“American.
The Los Angeles Medical Examiner’s Office report said that Perry’s death resulted from the “acute effects” of ketamine use, but it explained that other factors also contributed to the death, including “drowning,” “coronary heart disease,” and the effects of… Buprenorphine, a medication used to treat opioid addiction.
According to the Washington Post, the last dose of ketamine received by Perry, who passed away at the age of 54, was about 10 days before his death, and thus the coroner’s office clarified that “the high levels of ketamine” in his body “could not have been caused by… About a therapeutic dose.
Is ketamine safe?
When used under supervised conditions, and with careful patient examination, most doctors and health experts consider ketamine therapy generally safe, keeping in mind that all drugs carry some risks, especially when used without medical supervision and in off-label doses.
Accordingly, the use of ketamine without supervision and control may leave some harmful effects on the mental state, heart rate, and other vital signs.
Therefore, this treatment is recommended when the patient can be closely monitored by a healthcare provider, both during and after treatment.
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Ketamine is a controlled substance regulated by the Drug Enforcement Administration in the United States, and is subject to strict safety controls, due to its potential for abuse.
Doctors say that some concomitant medications may make ketamine treatment risky for some patients, so reviewing the patient’s medical history, especially with regard to mental health, is crucial before embarking on this treatment.
The American Society of Ketamine Physicians and Psychotherapists advises those who use this treatment “not to drive, work, care for young children, or engage in stressful tasks for the remainder of the day after taking the dose.”
In 2021, an international group of experts in mood disorders published research in the American Journal of Psychiatry, collecting evidence regarding some of the effects of two types of this treatment (esketamine nasal spray and intravenous ketamine).
The research noted that the drugs provide “opportunity and hope” for patients, but there is “an urgent need to clarify the long-term effectiveness of these agents, as well as important unanswered questions regarding safety.”
Last October, the US Food and Drug Administration issued a warning about compounded ketamine, as compounded medications are usually customized doses and combinations of medications made by pharmacists and have not been approved by the Food and Drug Administration.
The Food and Drug Administration has warned that using compounded ketamine products without monitoring by a healthcare provider for effects such as drowsiness and changes in vital signs, such as blood pressure and heart rate, may expose patients to severe risks.
In this regard, Gerard Sanacura, professor of psychiatry at Yale University School of Medicine, explained that ketamine can be a “life saver” for some patients, but many questions still remain regarding the scope of the disorders it may cause, adding: “It is not a cure.” A miracle for everyone.”
Who will benefit most from treatment?
Ketamine treatment, in general, is intended for people with serious mental illness who have tried other medications with little results.
It has been widely studied in people with treatment-resistant depression and severe suicidality, and may also benefit patients with conditions such as post-traumatic stress disorder, obsessive-compulsive disorder, bipolar depression, anxiety, and eating disorders.
A study published in the Journal of Clinical Psychiatry showed ketamine users at 3 clinics in Virginia showed a significant reduction in depressive symptoms.
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In the same study, an evaluation of more than 400 patients showed that 72 percent of patients experienced an improvement in their mood, and 38 percent were symptom-free after 10 injections.
The use of ketamine to treat psychiatric conditions is considered “off-label,” meaning it is legal for a doctor to prescribe the drug, but this indication has not been approved by the Food and Drug Administration.
The exception in this regard is esketamine, a nasal spray approved by the US Food and Drug Administration in 2019 and marketed under the name Spravato to treat treatment-resistant depression and severe suicidal ideation.
What is the evidence that the treatment works effectively?
Several studies show that ketamine can act as a fast-acting antidepressant, relieving symptoms in many patients within hours or days.
While long-term data are not available, some small, early studies have shown that treatment with ketamine significantly and quickly reduces symptoms of depression.
Here it should be noted that traditional antidepressants take 4 to 6 weeks to take effect, and sometimes they are not effective at all.
While traditional antidepressants can affect levels of certain brain chemicals associated with mood and emotion, ketamine affects a different neurotransmitter called glutamate, which is thought to work primarily by making the brain more flexible and receptive to treatment or alternative ways of thinking.
What happens during treatment?
Ketamine therapy is often given through an intravenous infusion lasting about 40 minutes, which is a low dose compared to when used as an anesthetic.
Intramuscular injections and tablets that dissolve under the tongue are also becoming more widely used, as esketamine nasal spray is taken with an oral antidepressant.
In a clinical setting, ketamine patients typically sit in a comfortable chair and listen to music while the treatment is administered.
The number of ketamine sessions can vary depending on each patient’s condition, but many providers suggest an initial course of 6 treatments over 2 to 3 weeks.
Talk psychotherapy, which often occurs after the effects of the medication have worn off, can also be part of treatment.
Esketamine (Spravato) is given twice a week for the first month, and can be taken once a week for the second month.
The patient remains under the doctor’s supervision for two hours after treatment, until any possible side effects disappear.
What does ketamine treatment look like?
Patients say that therapeutic ketamine can make a person feel happy and calm, while other patients begin to cry uncontrollably, or may appear visibly anxious.
Common side effects can include nausea, drowsiness, dizziness, poor concentration, and a feeling of disconnection from reality. High blood pressure also occurs, which is why monitoring during treatment is very important.
