Federal health authorities are intensifying their scrutiny of the drug ketamine for treating mental health disorders, as the mind-altering compound grows in popularity despite the lack of regulatory approval for such use. The Food and Drug Administration warned in October about the risks of using pharmacy-made ketamine at home, citing the case of one patient whose breathing slowed to a dangerous level after taking a large dose outside of a health-care facility. Then the autopsy of actor Matthew Perry, released Dec. 15, concluded a high dose of ketamine led to his death in October — an event that, while rare, drove home the dark side of the anesthetic that can also be abused recreationally, the Washington Post reports. These knocks come as the Drug Enforcement Administration continues to craft a rule that would set new limits on how health-care professionals can use telemedicine to prescribe tightly regulated drugs like ketamine.
Ketamine has been used as anesthesia in hospitals for decades and illicitly as a club drug. In more recent years, it has shown promise as a salve for depression when conventional antidepressants have failed. The FDA approved a ketamine derivative, the nasal spray Spravato, in 2019. Strict rules governing the use of Spravato have led many people to seek other ways of getting the drug that are legal but not FDA-approved. Clinics have sprung up to provide infusions, while some providers prescribe a tablet that can be taken at home. The rapid expansion of ketamine out of health-care settings and into patients' homes has heightened a debate among ketamine providers who see the drug as a critical tool for combating mental illness but disagree over how it should be used. “This is a wake-up call for ketamine practitioners and the wider medical community to put clear and unified guardrails in place guided by real-world data and medicine,” the nonprofit American Society of Ketamine Physicians, Psychotherapists, and Practitioners said after ketamine was implicated in Perry’s death. The group pledged to create guidelines for using ketamine at home.