{"id":1319,"date":"2024-09-03T12:07:18","date_gmt":"2024-09-03T12:07:18","guid":{"rendered":"https:\/\/retirednurseblog.com\/index.php\/2024\/09\/03\/has-ketamines-time-of-reckoning-arrived-5-things-to-know-after-matthew-perrys-death\/"},"modified":"2024-09-03T12:07:18","modified_gmt":"2024-09-03T12:07:18","slug":"has-ketamines-time-of-reckoning-arrived-5-things-to-know-after-matthew-perrys-death","status":"publish","type":"post","link":"https:\/\/retirednurseblog.com\/index.php\/2024\/09\/03\/has-ketamines-time-of-reckoning-arrived-5-things-to-know-after-matthew-perrys-death\/","title":{"rendered":"Has ketamine\u2019s time of reckoning arrived? 5 things to know after Matthew Perry\u2019s death"},"content":{"rendered":"

Editor\u2019s note:<\/em><\/strong> The podcast Chasing Life With Dr. Sanjay Gupta explores the medical science behind some of life\u2019s mysteries big and small. You can listen to episodes <\/em>here<\/em>.  <\/em> <\/p>\n

(The report listed drowning as a contributing factor; Perry was found face down in a hot tub at his home.) <\/p>\n

The actor\u2019s death raised questions about how ketamine is being used \u2014 and possibly misused \u2014 in a largely unregulated landscape that some critics liken to the \u201cWild West\u201d due to a proliferation of clinics around the country. Perry, who had struggled for years with drug addiction, had been open about receiving ketamine therapy for depression. <\/p>\n

\u201cMatthew Perry sought treatment for depression and anxiety and went to a local clinic where he became addicted to intravenous ketamine,\u201d Anne Milgram, the Drug Enforcement Administration\u2019s administrator, said at a recent press conference. \u201cWhen clinic doctors refused to increase his dosage, he turned to unscrupulous doctors who saw Perry as a way to make quick money.\u201d <\/p>\n

Prosecutors said a underground network of drug sellers and suppliers \u2014 including two doctors \u2014 were responsible for distributing the ketamine that killed Perry. Five people have been charged in connection with the death of the \u201cFriends\u201d actor. Three are cooperating with prosecutors, while two defendants have pleaded not guilty to respective charges that include falsifying medical records and conspiracy to distribute among others. <\/p>\n

To be clear, ketamine is only approved by the US Food and Drug Administration as an anesthetic and not for the treatment of any psychiatric disorder. (The FDA approved a related drug, esketamine, sold as Spravato, in 2019 for people with treatment-resistance depression.) <\/p>\n

But the scientific evidence showing that ketamine can be helpful in patients with treatment-resistant depression and suicidal ideation is strong and goes back at least 20 years. <\/p>\n

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Related article<\/span> Doctor charged in connection to Matthew Perry\u2019s ketamine case appears in court<\/span> <\/p>\n<\/p>\n<\/div>\n

Still, the circumstances surrounding Perry\u2019s death has brought scrutiny to the relatively new and somewhat misunderstood practice. <\/p>\n

\u201cOne of the major differences is that the actual setting and the patient\u2019s state of mind when they are receiving the treatment play a big role in the outcome, the therapeutic effect.\u201d <\/p>\n

You can listen to the podcast\u2019s full episode <\/em>here<\/em> <\/p>\n

Feifel, a professor emeritus of psychiatry at the University of California, San Diego\u2019s School of Medicine, was one of the first doctors to use ketamine off-label to treat depression at the school\u2019s Center for Advanced Treatment of Mood and Anxiety Disorders, according to an article in the journal The Lancet. <\/p>\n

Unlike traditional antidepressants that target the neurotransmitters serotonin and\/or norepinephrine, ketamine targets glutamate \u2014 the most abundant chemical messenger in the brain, Feifel said. It also appears to enhance neuroplasticity, stimulating new connections or pathways in the brain. <\/p>\n

Ketamine was originally developed in the 1960s as an anesthetic \u2014 an application for which it is still used today. (It is on the World Health Organization\u2019s Model List of Essential Medicines.) <\/p>\n

But Feifel said the drug\u2019s dissociative and hallucinogenic properties \u2014 which made it such a popular party drug \u2014  may hold the key to why it helps some people with depression and other mental health disorders. <\/p>\n

\u201cKetamine treatment is associated with an altered state of thinking, a psychedelic-like state of thinking, for a short period of time. There\u2019s a substantial amount of evidence that that is part of the therapeutic effect,\u201d Feifel said. \u201cThis psychedelic-like experience allows people to view things through a different lens that seems to play a role in their improvement.\u201d <\/p>\n

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Related article<\/span> Why it\u2019s important to prosecute celebrity drug deaths and the message it sends, according to legal experts<\/span> <\/p>\n<\/p>\n<\/div>\n

But, Feifel noted, it can be emotional and unpleasant for some \u2014 and it leaves patients undergoing treatment vulnerable because they are not fully in control of their faculties. As a result, proper preparation and supervision are essential, he said. <\/p>\n

Feifel said he started treating patients with ketamine because existing treatments don\u2019t work for everyone. <\/p>\n

\u201cWhen I started in psychiatry, one of the motivations was that I knew mental illness was an incredible scourge of society. The statistics are just unbelievable in terms of rates of depression, anxiety, PTSD (post-traumatic stress disorder) and suicide \u2014 and they are not getting better,\u201d he said. \u201cAnd after 50 years of medications, they really haven\u2019t gotten better. So there\u2019s a huge need.\u201d <\/p>\n

Here is what Feifel wants people to know about ketamine, especially if they or someone they know is interested in trying it. <\/p>\n

Ketamine needs appropriate medical supervision<\/h3>\n

Ketamine can be a lifeline for certain people who have not responded to common treatments for depression, such as medications and different forms of psychotherapy. <\/p>\n

\u201c(It\u2019s) probably the biggest advance in the field of mental health in terms of treatments in many decades,\u201d Feifel said. <\/p>\n

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Related article<\/span> How doctors and a \u2018Ketamine Queen\u2019 took advantage of Matthew Perry and played a role in his death, according to prosecutors<\/span> <\/p>\n<\/p>\n<\/div>\n

\u201cIt is highly effective when conventional (treatments) are not effective,\u201d he said. \u201cAnd its rapid effectiveness against suicidal thoughts (is) really important. We\u2019ve never had anything like that where we can give it to somebody \u2026 and it can, sort of, vaporize their suicidal thinking.\u201d <\/p>\n

And when done under appropriate medical supervision, ketamine is safe. <\/p>\n

\u201cIt is almost impossible to die from an overdose of ketamine alone,\u201d he said, because it doesn\u2019t lower respiration rates, \u201cwhich is very unusual for an anesthetic,\u201d and it has a wide therapeutic range. <\/p>\n

Feifel pointed out Perry\u2019s death didn\u2019t happen in a clinic under treatment. \u201cThere was no medical oversight,\u201d he said. \u201cThis was not given in anything that resembled a medical context.\u201d <\/p>\n

Caveat emptor (buyer beware)<\/h3>\n

If you are looking to try ketamine as treatment for depression or another mental health condition, do your homework. <\/p>\n

\u201cIf anybody is considering (ketamine therapy), they have to be somewhat cautious,\u201d Feifel said, \u201cbecause currently it\u2019s a very, unregulated landscape, where there are a lot of, let\u2019s say, providers that may not be (using it) under the highest standards. And then it can be risky.\u201d <\/p>\n

To find an appropriate provider or clinic, start by asking your psychiatrist. \u201cEven if they don\u2019t practice with ketamine themselves, (they) are probably aware of their local colleagues who do so, and the ones who have a good reputation,\u201d he said. <\/p>\n

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Related article<\/span> He never knew Matthew Perry, but prosecutors say the ketamine that killed him came from the actor\u2019s dealer<\/span> <\/p>\n<\/p>\n<\/div>\n

Look for an expert<\/h3>\n

Find a clinic run by a mental health professional. <\/p>\n

\u201cThe problem is many of these providers are not optimal,\u201d Feifel said. You wouldn\u2019t go to a urology clinic run by a psychiatrist, he noted, so why would you go to a ketamine clinic run by a urologist? <\/p>\n

\u201cIn general, a large proportion of the clinics are not run by mental health professionals, namely psychiatrists.\u201d <\/p>\n

Feifel said some clinics may do a good job but many don\u2019t. \u201cThey don\u2019t have the background,\u201d he said, pointing to a psychiatrist\u2019s years of residency and specialty training, not to mention deep understanding of complex medication regimens. <\/p>\n

\u201cRemember, the people who are coming to this treatment have the most resistant types of depression, the most complex, often with other mental illnesses commingled,\u201d he said. <\/p>\n

Look beyond the infusion<\/h3>\n

Seek out a clinic that includes psychotherapy as part of the treatment plan. <\/p>\n

\u201cThe highest standard is to do ketamine treatments in the context of the specialized type of psychotherapy called ketamine-assisted psychotherapy,\u201d Feifel said. \u201cA provider that also has a multidisciplinary team that includes licensed therapists who are trained in this \u2014 that\u2019s a barometer of a very high level of commitment to the best practices in ketamine.\u201d <\/p>\n

You don\u2019t want to walk into a clinic, get an infusion and then be sent on your way without proper follow-up support, he said. <\/p>\n

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<\/span>video <\/div>\n<\/p>\n<\/div>\n

Related video<\/span> What is ketamine, the drug involved in actor Matthew Perry\u2019s death?<\/span> <\/p>\n<\/p>\n<\/div>\n

Steer clear of telehealth providers<\/h3>\n

During the height of the pandemic, rules around prescribing controlled medications, such as attention deficit hyperactivity disorder drugs, were relaxed to allow for continuation of therapy. This flexibility of the prescribing rules could spell trouble for someone getting ketamine therapy via telehealth. <\/p>\n

\u201cThere are companies now that will have patients do a quick telemedicine consultation with, let\u2019s say, a nurse practitioner \u2026 just to check that box that there was a medical assessment, and then they get sent ketamine to their house to do on their own,\u201d Feifel said. \u201cThat\u2019s exactly part of the problem: doing it on your own, unsupervised (and) thinking, \u2018Oh, this is fine.\u2019\u201d <\/p>\n

He said people should steer clear of home ketamine, at least initially. \u201cI think it\u2019s a recipe for disaster,\u201d he said. <\/p>\n

Feifel said he believes the public can separate what happened to Perry from the promise of ketamine therapy. <\/p>\n

\u201cThere are people who traffic in drugs and, unfortunately, people who get addicted to drugs, even drugs that are relatively low on the addiction potential scale as ketamine is,\u201d he said. \u201cSo, I think people in their minds will separate this. \u2026 That is not medical care.\u201d <\/p>\n

Listen to the full episode here. Starting next week, new episodes of the Chasing Life podcast will be released on Fridays. <\/em> <\/p>\n<\/p>\n

This post appeared first on cnn.com<\/div>\n\n","protected":false},"excerpt":{"rendered":"

Editor\u2019s note: The podcast Chasing Life With Dr. Sanjay Gupta explores the medical science behind some of life\u2019s mysteries big and small. You can listen to episodes here.   (The report listed drowning as a contributing factor; Perry was found face down in a hot tub at his home.) The actor\u2019s death raised questions about how …<\/p>\n","protected":false},"author":1,"featured_media":1320,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"loftocean_post_primary_category":0,"loftocean_post_format_gallery":"","loftocean_post_format_gallery_ids":"","loftocean_post_format_gallery_urls":"","loftocean_post_format_video_id":0,"loftocean_post_format_video_url":"","loftocean_post_format_video_type":"","loftocean_post_format_video":"","loftocean_post_format_audio_type":"","loftocean_post_format_audio_url":"","loftocean_post_format_audio_id":0,"loftocean_post_format_audio":"","loftocean-featured-post":"","loftocean-like-count":0,"loftocean-view-count":587,"tinysalt_single_post_intro_label":"","tinysalt_single_post_intro_description":"","tinysalt_hide_post_featured_image":"","tinysalt_post_featured_media_position":"","tinysalt_single_site_header_source":"","tinysalt_single_custom_site_header":"0","tinysalt_single_custom_sticky_site_header":"0","tinysalt_single_custom_sticky_site_header_style":"sticky-scroll-up","tinysalt_single_site_footer_source":"","tinysalt_single_custom_site_footer":"0","footnotes":""},"categories":[35],"tags":[],"class_list":["post-1319","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-news"],"_links":{"self":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts\/1319","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/comments?post=1319"}],"version-history":[{"count":0,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts\/1319\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/media\/1320"}],"wp:attachment":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/media?parent=1319"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/categories?post=1319"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/tags?post=1319"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}