A growing number of startup companies are getting into the business of prescribing ketamine, an FDA-approved mind-altering anesthetic drug, to patients for mental health conditions such as depression, suicidal thoughts, and PTSD, for which it is not authorized. Increasingly, psychiatrists are voicing concerns about the practice, saying that prescribing the drug off-label and sometimes at very high doses poses, for use at home, considerable risks. Ketamine should only be used in hospitals with medical supervision for its intended purpose—anesthesia. Some studies suggest that ketamine can alleviate some symptoms of depression when other treatments have failed, but there is little data on the drug’s effectiveness for anxiety and PTSD, and no evidence of the impact of its long-term use. The companies sell ketamine in tablets and lozenges online, making use of relaxed, pandemic-era rules on prescriptions, based on a questionnaire and virtual evaluation. But physicians warn that taking ketamine at home and without proper medical supervision increases the risks of patients falling and hurting themselves. The drug, which is also popular with party goers, can be addictive and increase the risk of complications including stroke or heart attack at higher doses. With growing interest in ketamine and other mind-altering substances such as psychedelics, it’s essential to closely monitor prescribing and use, as research has not yet established clear guidelines on dosages, side effects, and best practices.
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