Everything A Ketamine Clinic Owner Needs To Know About Ketamine's History
In this blog, learn about key milestones in ketamine's history from an animal anesthetic to a widely used medicine and now, an emerging therapy for conditions like pain and mood disorders. Plus, why you should care about history when you start your ketamine clinic.
Why Care About The History of Ketamine?
You may be thinking, "I only need to know how to use this drug and watch for side effects. Just give me the treatment protocol!" But there's more to it. Understanding ketamine's origins and evolution will provide insight into educating the public on this often misunderstood medicine and respecting its potential as a transformational therapy. So let's dive in!
The history of ketamine began with PCP, which had severe side effects on human trials including schizophrenic-like behaviors. A safer alternative to PCP was later invented, called ketamine.
Can’t Talk about Ketamine Without Talking About PCP
Ketamine's story began in 1956 with the synthesis of phencyclidine (PCP). In search of a new anesthetic, researchers began to test PCP on humans. However, human trials revealed severe side effects that would make PCP infamous as a drug of abuse today. Rather than calmly awakening, some patients experienced emergence delirium lasting hours post-surgery. They described disturbed sensations like numbed limbs or sensory deprivation - which can provoke hallucinations, anxiety, and depressed mood when forced unexpectedly.
Further PCP research found it could induce schizophrenic-like behavior in participants. These unmanageable psychiatric effects, alongside the prolonged emergence delirium, motivated the search for a safer anesthetic alternative.
Ketamine Is Born
Seeking an alternative, Dr. Calvin Stevens of Wayne State University synthesized a series of phencyclidine derivatives. One compound, CI-581, emerged as a promising short-acting anesthetic in animal studies. This drug was later renamed "ketamine" for the ketone and amine group in its chemical structure.
The first human was given intravenous ketamine on August 3, 1963. Study participants experienced minimal emergence delirium, and described having a floating-in-space like experience. They stated they felt like they were disconnected from their body and environment. Due to these descriptions and desire to avoid the term “psychedelic” at this time, the creators of this medication called it a “dissociative anesthetic” - a designation still used today. Following FDA approval in 1970, ketamine saw use on soldiers in Vietnam given its safety profile for battlefield conditions.
For decades, ketamine has been known as an anesthetic and used everyday in hospitals. It eventually changed when ketamine was found to have antidepressant effects and eased not only physical pain, but also psychological.
Ketamine: A Hospital Workhorse
Though often known by laypeople as a "horse tranquilizer" or street drug, ketamine is an essential medicine used everyday in hospitals around the world. This anesthetic is suitable for patients from children to the elderly, with minimal respiratory depression. Its ability to increase blood pressure also makes ketamine useful in traumatic shock. The dissociative properties allow ketamine to facilitate procedural sedation. In fact, the World Health Organization lists ketamine as an essential medication for all hospitals. For decades, ketamine was confined to anesthetic use in the ER and OR. But that would eventually change.
A New Use For Ketamine
Starting in 1994, research expanded beyond acute pain relief to study ketamine's effects on chronic pain syndromes like fibromyalgia and migraines. Later research would find ketamine not only eased physical pain, but also psychological. But an unexpected finding occurred in a study using low-dose ketamine as a model for schizophrenia - depressed participants experienced antidepressant effects.
This spurred further research, including the first randomized double-blinded controlled trial published in Biological Psychiatry in 2000. Dr. Berman and colleagues reported rapid antidepressant effects from ketamine in patients with depression (Berman et al., 2000). In 2012, ketamine was hailed as the "biggest breakthrough in depression research in a half century." Further studies have shown promise for ketamine in treating OCD, PTSD, anxiety, and suicidal ideation.
There is much misinformation about ketamine. Educating yourself about ketamine’s history will help you enlighten and educate others as well.
Conclusion: Utilizing Ketamine’s History in Practical Terms
So you’ve skimmed this blog, and now you may be thinking, “What do I do with this knowledge?” Address the misinformation regarding ketamine. As a clinic owner and future ketamine specialist, you'll encounter criticism based on misunderstandings about ketamine as solely a street drug, rather than an essential medicine used worldwide with proven benefits. You can do this via your clinic’s website and social media posts, or when you are having a conversation with a potential patient or referring provider. It is still early days in the ketamine treatment industry. Understanding and acknowledging its past can help us appreciate this unique medication as our field grows and matures.
Reference:
Domino, E. F. (2010). Taming the Ketamine Tiger. Anesthesiology,1. doi:10.1097/aln.0b013e3181ed09a2
Related Questions
What are some effective ways to communicate ketamine's history and debunk misconceptions through my clinic's website and materials?
Your website should address any question your patient may have from what is ketamine to what to expect during their treatment with you. Some basic “must-haves” are an FAQ page and a “What Is Ketamine” or similarly titled page. The key with effective communication regarding ketamine therapy, is to remember where your patient is coming from by anticipating their concerns and needs.
Are there any major studies on ketamine's benefits that I should be familiar with when speaking to colleagues?
The “Antidepressant effects of ketamine in depressed patients” article included in the reference section of this blog is basically the major study that launched ketamine therapy or treatment depression. The following are two other studies definitely worth knowing:
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