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The Evolution of Ketamine Treatment

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Steven P. Levine, MD, a board-certified psychiatrist and therapist who currently practices in Princeton, NJ, details the history of ketamine from its original development as a general anesthetic through its clinical use today as an antidepressant in patients presenting treatment-resistant depression.
 
According to Levine, ketamine “cut its teeth” as a battlefield anesthetic in the Vietnam War, where it was known as a “buddy drug” because it could be quickly and safely administered by a soldier’s “buddy in the field.”
 
However, Levine points out that ketamine’s mechanism had already been studied as an anti-depressant throughout the decade leading up to the war. Even so, it wasn’t until the late 1990s that an early pilot study showed “remarkable results” with the indication, and though ketamine has had a “long research track record” since that initial study, the drug “really wasn’t used clinically outside of the research setting until the past few years.”
 
Despite the drug’s late clinical adoption, Levine says ketamine is a viable option for treatment-resistant depression because it has “a very different mechanism and a very different pattern of effect and group of side effects” compared to typical antidepressants.

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