Recently, a small study was conducted by a team at Stanford University and their conclusions were published by The American Journal of Psychiatry. Results of the study spread far and wide among mainstream press and science/tech publications. The study provides a suggestions that Ketamine activates the brain’s opioid receptors (which control reward/addiction) in addition to what has been known all along, that Ketamine activates the brain’s glutamate system (which controls learning/memory).
Studies which seek to better understand Ketamine’s profile in relation to it’s therapeutic application are a net benefit to the industry and patients alike, however it is also important to note that this study was terminated early, featured a small sample size (12 people), and might benefit from replication. Additionally, it may be possible that the dissociative effects of ketamine are not mediated by the opioid system but rather just require it to be healthy and active, in relation to achieving antidepressant benefits.
Yale psychiatrist, Gerard Sanacora, who studies Ketamine., said the following about the study’s findings: “Everybody can be quick to jump to the conclusion that, ‘Oh it’s working through the system, but this study doesn’t show that at all. It just shows that normal functioning of the system seems to be necessary to get the effect.”
Dr. Mark Murphy, Medical Director at Ketamine Wellness Centers, had the following to say in reaction to the study:”This is a very small study that makes a suggestion of Ketamine involvement with opioid receptors. Nothing more. Show me the actual pharmacodynamics (i.e., how it acts cellularly in the opioid system). Here are the facts: Ketamine has been safely used in the anesthetic setting for decades simply because it doesn’t carry the risks that are characteristic of opioids. The European Monitoring Centre for Drugs and Drug Addiction noted 12 deaths related to Ketamine between the years 1987-2000. Three of those twelve deaths involved Ketamine as the sole substance. In 2016 alone in the US, there were 42,249 deaths related to opioid abuse. Ketamine is incredibly safe and if it is found to have physiologically similar benefits, without the addiction potential of opioids, it further supports its efficacy and safety.”
It should also be mentioned that two of the authors on this paper held consulting roles with Allergan, Johnson & Johnson, and VistaGen, all pharmaceutical corporations currently developing Ketamine-esque drugs for the treatment of Depression.
At the end of the day, we welcome research an studies to help us better understand Ketamine. We have been treating patients for over seven years, performed over 10,000 infusions, and have patients who have been coming back to us for years. These people are miles ahead in terms of their progress compared to when they first came to us. Furthermore, in the time that we have been administering these low-dose infusions, we have not seen any of our patients become addicted to Ketamine. This includes patients that have been treated by our clinic for multiple years and patients that have begun Ketamine infusions while addicted to other substances.