When & How Did Ketamine First Make An Appearance In Psychiatry?

When & How Did Ketamine First Make An Appearance In Psychiatry?

Ketamine has a reputation like a pinball. Depending on who’s playing, you never know where it’ll bounce or ricochet or what kind of response it’ll elicit from whoever’s in the game. Its history has been muddled in controversy, but the medicine has begun enjoying a renaissance as more people accept its value beyond anesthesia.

But when did it become something of a fixture in psychiatric circles? Officially, from a U.S. government perspective, only in the last several years. But ketamine’s history goes way beyond that, and to look to the future, you must first look at the past.

Ketamine was first synthesized in 1962 by a researcher and consultant named Calvin Stevens, who was doing work for the pharmaceutical company Parke-Davis. His goal was simple: Find a less volatile alternative to phencyclidine, more commonly known as PCP. The problem with PCP? It “was capable of causing the appearance of drunkenness in rodents, delirium in dogs, cataleptic states in pigeons and anesthesia in monkeys. Although demonstrated to be a safe and reliable anesthetic in humans, it also caused an intense, prolonged emergence delirium that ultimately made it undesirable for human use.”

A few years later, Dr. Edward Domino held the first human trials of ketamine, using incarcerated male prisoners at Michigan’s Jackson State Prison as his subjects. With higher doses, ketamine rendered people unconscious, but Domino noticed that it created odd psychotropic effects on otherwise rational patients at lower ones. The pharmaceutical company wanted to avoid describing the drug as psychedelic, and the doctor’s wife came up with the term “dissociative anesthetic” to explain the way ketamine appeared to carve the mind away from the body even while someone’s mind retained awareness.

Soon afterward, ketamine received more widespread testing, this time on injured U.S. combat troops fighting in Vietnam. The medicine’s anesthetic value was indisputable, but, like Dr. Domino and his wife, others soon realized it had dissociative properties reminiscent of drugs like LSD and other psychedelics. Thus, it became trendy within U.S. counterculture circles.

Other Notable Dates In Ketamine History

  • The 1970s. With results of promising trials safely documented, the U.S. Food and Drug Administration (FDA) approved ketamine for official use as a human and animal anesthetic in 1970. It soon became a mainstay in illicit drug circles, starting on the West Coast in the early 1970s. But ketamine’s march to respectability beyond the realm of anesthesia was also inevitable. During the 70s, psychiatric and academic studies on its ability to treat symptoms of mental illness and chronic pain conditions began in earnest.
  • The 1980s. People started using the medicine as a party drug, and it spread like wildfire across the United States.
  • The 1990s saw ketamine achieve something akin to favored-nation status as a party drug, and the U.S. Drug Enforcement Agency classified it as a controlled substance to control illicit use.
  • The 2000s. Once ketamine became a controlled substance, its usage legally and illegally was substantially curtailed. Morphine became a popular anesthetic, but medical professionals began observing and researching ketamine’s proficiency to reduce depression and suicidal thoughts quickly during this decade. Additional studies ultimately showed the medicine was a legitimate alternative therapy for treatment-resistant depression, with the U.S. FDA approving it for that use in 2019.

Which Conditions Can You Treat With Ketamine?

Ketamine’s appearance in psychiatric circles happened 50 years ago, but its formal introduction to treating depression only occurred recently. Besides depression, it’s used to treat a wide range of other conditions, including anxiety disorders, mood disorders, and chronic pain. The medicine is mainly dispensed intravenously in doctor’s offices, medical facilities, and licensed clinics nationwide. Ketamine has been used to treat symptoms of:

  • Generalized Anxiety Disorder, known for long-term anxiety, overstated worry and tension, even without provocation.
  • Obsessive-Compulsive Disorder, which is characterized by recurring, unwanted thoughts (obsessions) and behaviors (compulsions).
  • Panic disorder, which is characterized by unforeseen and repeated periods of intense panic accompanied by symptoms like chest pain, shortness of breath, heart palpitations, dizziness, or stomach discomfort.
  • Post-Traumatic Stress Disorder, which can happen after experiencing or witnessing a terrifying, sometimes deadly, event.
  • Bipolar disorder, where someone has instances of depression alternating with episodes of mania or high moods.
  • Chronic pain, which is any pain that lasts for more than six months, doesn’t respond to treatment, and may happen long after an injury, illness, or medical condition subsided or was healed.