Ketamine - A Brief History, its Uses, and Possible Future
Historically, doctors and other medical professionals have tirelessly searched for new ways to treat post-surgery pain and reduce recovery time. In the last 50 years, medicine has improved dramatically; countless scientific breakthroughs have led to the discovery of many new and improved treatment options. Until recently, ketamine was used solely as an anesthetic, however, in recent years, medical and psychological researchers have consistently observed ketamine’s ability to treat a myriad of mental health conditions. The following is a brief history of ketamine and its uses over time.
1950's Anethesia PCP
In the 1950’s doctors and chemists were working to synthesize new anesthetic drugs with analgesic properties. Physicians needed a better way to reduce surgery pain and treat a variety of pain management situations. Originally PCP (phencyclidine) was discovered by Parke-Davis and Company's laboratories in Detroit, Michigan, USA. and appeared to meet these criteria.
Although PCP was effective at providing analgesia in animals, some problems developed with the animals tested. Muscle relaxation was poor, among other symptoms. It was the hope that human trials would prove more effective. PCP was given the trade name of Sernyl and started being used on patients. Although Sernyl proved to be a powerful anesthesia, there were many side effects that proved undesirable and overall, patients experienced more adverse side effects than comparable medications. As a result, it was determined that the PCP was not suitable as an anesthetic with analgesic properties.
1960's Ketamine is Created
Following the development of PCP, ketamine, a close structural analog, was first synthesized in 1962. In 1964, ketamine treatments were first tested on volunteer prisoners. The participants described feeling like they were floating in outer space, with no feeling in their limbs. Some patients also described feelings of dying. Ketamine was found to have many of the same anesthetic and analgesic properties as PCP, but consistently produced fewer adverse side effects. Following this initial research, ketamine was characterized as a dissociative anesthetic.
1970's French Clinical Trials
In the 1970s, clinical trials for ketamine infusions began in France. The researchers found that ketamine was a potent analgesic but was comparatively less potent and significantly shorter in duration than PCP. The researchers also noted that one of the main side effects of ketamine was hallucinations, which was considered undesirable for clinical practice at the time. In the U.S., the FDA approved ketamine’s use as a field anesthetic for soldiers during the Vietnam war.
As a result of ketamine's perceived abuse potential, psychedelic-like symptoms, and the introduction of other drugs like Propofol, ketamine was used less as a medical drug by the end of the 1970's. From 1978 onward, ketamine became a Class III substance under the US Controlled Substances Act in 1999.
Recent research by Harvard 2019 into Ketamine and Depression and John Hopkins University in 2019 have uncovered its ability to treat a variety of mental health conditions. Ketamine for treatment-resistant depression has been the most well researched, however ketamine has also been observed in our clinic to possibly help with anxiety, PTSD, and chronic pain related to nerve pain, migraines, CRPS, fibromyalgia, neuropathy. Ketamine’s antidepressant qualities have stood out from traditional antidepressants, due to its reliability in producing dramatic changes within hours, rather than weeks or months. The studies surrounding certain types of pain is ongoing.
Ketamine is widely used in medical settings; ketamine injections and nasal spray continue to aid for a variety of issues in productive ways.
We will continue to observe a multitude of mental health outcomes following ketamine treatments. Hopefully we will see more patterns emerge with proper use, correlating patients' identities and life experiences with specific positive mental health outcomes.
Edward F. Domino, David S. Warner; Taming the Ketamine Tiger. Anesthesiology 2010; 113:678–684 doi: https://doi.org/10.1097/ALN.0b013e3181ed09a2
Li, L., & Vlisides, P. E. (2016). Ketamine: 50 Years of Modulating the Mind. Frontiers in human neuroscience, 10, 612. https://doi.org/10.3389/fnhum.2016.00612
Wei, Yan & Lijia, Chang & Hashimoto, Kenji. (2020). A historical review of antidepressant effects of ketamine and its enantiomers. Pharmacology Biochemistry and Behavior. 190. 172870. 10.1016/j.pbb.2020.172870. https://doi.org/10.1016/j.pbb.2020.172870
Waun'Shae Blount (2019) Psychiatry and Behavioral Sciences Ketamine Isn’t an Opioid and Treats Depression in a Unique Way https://www.hopkinsmedicine.org/news/newsroom/news-releases/ketamine-isnt-an-opioid-and-treats-depression-in-a-unique-way