Ketamine Korner: Edition 1
Ketamine Korner is a bi-weekly newsletter exploring advances in ketamine therapy, originally started by Mind Pain Relief Institute Co-Founder Dr. Rohit Aiyer.
Each edition is republished with permission from Dr. Aiyer.
Latest Research:
Research Update: A study published in Science in May 2025, “Enhanced ERK activity extends ketamine’s antidepressant effects by augmenting synaptic plasticity”, found a way to sustain ketamine’s antidepressant effect. By using a drug called BCI to inhibit a key protein phosphatase, Vanderbilt University researchers maintained ERK (extracellular signal-regulated kinase) activity, enhancing synaptic plasticity. The result: ketamine’s antidepressant benefits lasted up to two months in preclinical models. While BCI itself may not be clinically viable, the study shows that targeting intracellular signaling pathways could potentially extend ketamine’s therapeutic effects (Vanderbilt University).
A Brief History of Ketamine in Mental Health:
Origins: Ketamine entered U.S. medical use in 1970 as an anesthetic, including on the battlefield during the Vietnam War (Johns Hopkins Public Health, Restorative Health Primary Care).
Early Psychiatric Exploration: In 1973, studies using ketamine infusions with psychotherapy reported improvements in mental health (Transcend Ketamine).
Antidepressant Breakthrough: Around 2000, its psychiatric potential resurfaced when rapid antidepressant effects were observed, often within hours of a single dose (Vanity Fair).
Modern Era and Regulatory Milestones: Esketamine (Spravato), intranasal ketamine, received FDA approval in 2019 for treatment-resistant depression under controlled conditions as an adjunct treatment (Harvard Health, Wikipedia). In January 2025, Spravato received FDA approval as monotherapy for major depression in patients unresponsive to at least two oral antidepressants (Johnson & Johnson press release, AJMC, UTHealth).
Mythbuster — Challenging Traditional Misconceptions about Ketamine Therapy:
Myth: Ketamine therapy is experimental, unregulated, and risky.
Reality: Clinical Adoption and Regulation: Intranasal Ketamine (Esketamine, “Spravato”) has been FDA-approved since 2019, with strict REMS guidelines, as an adjunct to antidepressant therapy. In 2025, Spravato also received approval as a monotherapy (FDA/J&J).
Medical Supervision is the Standard: The American Society of Anesthesiologists (ASA) recommends ketamine only be administered by medical professionals with appropriate training.
Evidence-Backed and Beneficial: Large robust clinical studies show IV and intranasal ketamine rapidly reduces depressive symptoms in treatment-resistant cases (New Pathways Clinic, SELF, Northwestern Medicine).
Known Risks, Managed Effectively: Side effects such as dissociation, blood pressure changes, and misuse potential are well-documented and manageable under medical protocols (SELF, Vox).
As the science evolves, so does our understanding of ketamine’s place in modern psychiatry. Staying informed helps us separate fact from myth and see where the future of treatment may lead.
Until next time, stay curious and engaged with the possibilities ahead.