Through ketamine fields: pain and afterglow

Depression has surpassed HIV/AIDS, malaria, diabetes and war as the leading cause of disability and economic burden worldwide. It is the most common psychiatric disorder in developed countries. Another major public health issue is chronic pain. In Europe, pain is the most common cause for people to use healthcare resources. Nevertheless, there are no universally accepted treatment guidelines for treating chronic pain. The well-known anaesthetic agent ketamine appears as an interesting and promising management drug for both conditions. A single dose of ketamine alleviates depressive symptoms within minutes in patients who have failed to respond to two or more conventional antidepressants and these effects are sustained for one week to months. Ketamine is also effective for bipolar depression, it decreases suicidal ideation and has shown positive results in the treatment of other mental conditions, such as post-traumatic stress disorder, and obsessive-compulsive disorder. Furthermore, ketamine has shown antidepressant effects in patients who do not respond to electroconvulsive therapy. Therefore, the off-label use of ketamine (i.e. using it for different purposes than anaesthesia) is increasingly common in the medical setting. In order to treat patients who are refractory to depression and chronic pain treatments, healthcare professionals are claiming compassionate reasons to obtain the authorisation to use ketamine as an antidepressant and/or analgesic. However, ketamine is a mood enhancer and its hedonistic use is widespread. Under medical surveillance and based in growing scientific evidence, the current psychedelic renaissance is bringing a new paradigm in the treatment of different types of disorders