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The rise of ketamine as a depression treatment

Ketamine clinics claim the drug's effects, in controlled, low doses, dramatically improve depression symptoms. But how ketamine achieves those dramatic results is giving some professionals pause.

WOODBURY, Minn. — Nestled in a retail complex in Woodbury, the Minnesota Ketamine Clinic does steady business.

Nineteen-year-old Kyle Eason is about to receive the commonly used anesthetic.

But Kyle isn't here for a surgery. He's here for a depression treatment - a use of the drug that's considered off-label, or not fully approved by the FDA.

"It's kind of like you're not connected to your body," Kyle says. "You're just in your head."

Those psycho-active effects are what led to ketamine's controversial rise as a party and date-rape drug.

But ketamine clinics claim those same effects, in controlled, low doses, dramatically improve depression symptoms in people of all ages.

"We've seen patients as young as 14 years old," says Dr. Greg Simelgor.

Simelgor is an anesthesiologist, not a psychiatrist. But he says he knows ketamine works for his patients.

"They go from, 'The world is going to be much better without me,' to, 'I want to go back to school.'"

Kyle is one of those patients.

"I can actually get to sleep now and not stay up from my bad thoughts," he says.

Severe depression and anxiety began at age 14, causing him to miss almost an entire year of school.

"It was scary," Kyle's mother, Michele, says. "I can't tell you how many emergency room visits we've had in the middle of the night."

Michele says they tried every standard treatment they could.

"It was trial and error for at least two years with different medications and different doctors," she says.

Then, Kyle read about a ketamine trial at the University of Minnesota.

"I said, 'Hey, we have teens that are severely depressed and treatment resistant that have no options," said Associate Professor of Psychiatry Kathryn Cullen. 

She soon found several patients and parents willing to sign up.

"The fact that it seems to have such a rapid effect, we don't have anything like that in psychiatry," she says. "And so, people have ... really grabbed onto it as almost like a miracle."

Infusions are not cheap. They cost about $500 each and are not covered by insurance.

"When you hear your kid say, 'I don't know why I was ever put on this earth', I mean, you just... want to get the best thing for them you can," Michele says.

In the study, patients received six, low-dose, ketamine infusions over two weeks. Of the 13 patients who took part, five of them reported at least a 50 percent reduction of symptoms. 

"That was a little lower rate of response than I was expecting and hoping for," says Cullen. "I still think it's a potentially promising avenue."

That's because Kyle and the others who did respond, reported dramatic improvement.

"He wasn't the depressed Kyle, even that first night," Michele says. "And by the weekend, we literally had our Kyle back."

"It's not easy to describe," Kyle says. "When I first had it, I kind of described it as a magic bullet."

But how ketamine achieves those dramatic results is giving some professionals pause.

"We do know that ketamine is addictive in some individuals," says Nolan Williams. He and his colleagues at Stanford University found that ketamine is efffective, in part, because it acts like an opioid in the brain.

"My sense is, that in the scheme of things, it's not as dangerous as a standard opioid to give, but," he says, "we really should be trying to try everything ... before we go into something like ketamine."

"Although I can't say that it's completely risk free," Cullen says. "I think it's got a place."

Cullen says more research is needed, but knows the clinics aren't going anywhere.

"They're seeing it turn patients lives around, so that keeps them going," she says.

"I've been in the lobby here, listening to other people talk and I've heard people say the same thing, 'Got my son back,'" Michele says. "And then I'll just start crying and, 'You too?' And I'm like, 'Yeah.'"

The FDA is currently evaluating a ketamine nasal spray, which would be the first approved use of the drug to treat depression.

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