Ketamine gives hope to depressed patients in the face of surveillance, addiction and abuse concerns

Ketamine has been hailed as a breakthrough treatment for depression and other disorders. The drug was also in the limelight this week as doctors revealed its key role in the overwhelming rescue of a Thai football team trapped in a cave last year.

But the history of ketamine as the illicit drug of the triptych party worries some of them.

The Food and Drug Administration recently approved a version of this treatment while a growing cottage industry of ketamine infusion clinics is still operating with minimal oversight.

Some scientists would like patients and practitioners to wait until there is more solid research on the long-term effects of the drug.

But Kimberley Curda, who is receiving ketamine treatments, said patients who desperately needed help did not have much time left.

"Suicidal thoughts are in my head all the time," she said. "It's not like I'm planning, but rather as a way out."

Joanne Sanin also battled suicidal thoughts.

Sanin has been experimenting with antidepressants, behavioral therapy and more during his many years of fighting severe depression – with little or no success. She explained that there were many mornings when she would wake up upset to have to face a new day. She said that it was frustrating not being able to appreciate her wonderful family and the beautiful life she was leading.

When she heard an advertisement about ketamine infusions in the treatment of severe depression, she felt like it could be her last chance.

"For someone who has hit the bottom, there is no more waiting," she said.

WATCH: "What the years could not do for me in 45 minutes" – Joanne Sanin discusses ketamine infusions

Intravenous ketamine is now offering a lifeline to patients like Sanin.

The effects are sometimes felt in a few hours: the drug produces a dissociative state, which patients describe as a floating sensation.

This effect made a form of ketamine powder popular on the psychedelic drug scene in the 1990s. Previously, the drug had been used as an animal tranquilizer in the 1960s and as an effective anesthetic for humans in the 1970s.

More recently, some doctors have given ketamine to people without the official approval of the FDA.

Approximately 150 ketamine treatment clinics operate throughout the country, including at least half a dozen in the Chicago area.

Dr. Rahul Khare is the founder of Innovative Express Care in Chicago. He added that his clinic carefully examines patients and successfully treats depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and pain.

Khare is certified by the Emergency Medicine Council and says she uses evidence-based drugs and guidelines to decide on the dosage of ketamine for each patient.

"So our protocol is that you get an infusion of ketamine every other day for two weeks – so six infusions – and then we do it every month," Khare said.

Curda is one of his patients and believes that the treatments work.

WATCH: "It was a total gamechanger" – Kimberley Curda explains how ketamine treatments saved her

"I noticed that I reacted differently to life, I handle situations differently, I do not wake up feeling that I should not be here," she said.

The availability of this treatment is increasing with the recent approval by the Food and Drug Administration of a nasal spray treatment containing a chemical ketamine cousin. The brand name is Spravato, but its chemical name is Esketamine.

The new drug has been approved as a fast-acting treatment for patients who have failed to find relief with at least two traditional antidepressants and will only be available through a rigorous distribution and surveillance system.

According to the FDA, nearly 7.4 million American adults suffer from "treatment-resistant depression," which increases the risk of suicide, hospitalization, and other serious injuries.

Intravenous ketamine is a generic and is used "off-label" to treat depression and other disorders, which means it has not been officially approved by the FDA. Unregistered use on the label often means less regulatory oversight, as is the case for many other drugs.

Spravato will cost between $ 590 and $ 885 depending on dosage and before various discounts and rebates.

Patients often pay hundreds of thousands of dollars for intravenous infusions of the drug over several weeks or months. These therapies are generally not covered by insurance as they have not been approved as safe and effective by FDA regulators.
Dr. Mark Rasenick has been studying the effects of ketamine at the University of Illinois Medical Center for years. He called the drug "revolutionary," but said he still had his concerns.

"It's still a dangerous drug and we have no idea of ​​the consequences of long-term use," Rasenick said.

Rasenick said that ketamine appeared to be effective and safe for the treatment of depression in the short term, but he worried about the lack of surveillance of intravenous clinics, especially as the potential Ketamine abuse is very high. He advocates more rigorous studies and less hype.

Chicago Customs and Border Protection officials say they still attack illegal ketamine, much of which comes from the Netherlands in the Chicago area.

US anti-drug officials told I-Team that their agents were preparing for the summer concert season, during which street ketamine will be making its comeback. Officials had no predictions about the growing popularity of clinics in illicit sales in Chicago.

Nevertheless, some addiction specialists predict that the demand for inexpensive street ketamine will increase because it is much cheaper than medications administered by doctors.

Dr. Indra Cidambi, an addiction specialist and medical director of the New Jersey Center for Network Therapy, says that drugs given in clinics are low-dose and have a lower risk of abuse. However, Cidambi is concerned that the demand for inexpensive street ketamine will be increased if treatment in an appropriate clinic is too expensive or inaccessible.

"The black market price is $ 10 for 10 milligrams, we can not forget it," she said. "They do not know what dose they are getting on the street and it's also a concern.This can be reduced with heroin and / or fentanyl, it can cost life now," Cidambi said. .

Dr. Bal Nandra, an anesthesiologist in Chicago, is the founder of IV Solution, an infusion clinic that has been operating for two years in Chicago's Near North Side. He said the medication had a very safe profile if it was appropriately administered by a person with the appropriate training and expertise. He also does not expect an increase in the use of ketamine in the street because it does not create addiction like opioids.

Ketamine can stimulate the sympathetic nervous system and increase heart rate and blood pressure. Doctors who administer the drug must be able to handle any problems that may occur during treatment, said Nandra.

Nandra said that he had achieved impressive results in treating difficult depression – sometimes exceeding the expected success rate of 80%. He also uses ketamine to treat a variety of conditions, including chronic pain and migraines.

Many clinics, including Nandra's, offer payment methods to make procedures more affordable.

Sanin is his patient.

"In four days, they have done for me what I've been trying to do for over 20 years, it's amazing," she said.

The I-Team spoke with several physicians who administer ketamine, all of whom claimed to follow good standards of care based on scientific research. They encourage consumers to do their homework at the clinic and the provider who will administer the drug.