Why is the medical community slow to accept ketamine for mental health disorders?
If you are reading this article, then you are likely already aware of the potential of ketamine infusions for the treatment of depression, PTSD, suicidality, and anxiety. Unfortunately, the majority of people are unaware this is an option, or if they are aware, they simply believe ketamine is “just a horse tranquilizer” and drug of abuse that has no benefits in the treatment of mood disorders.
Humans don’t like change, and the medical community is made up…of well humans. Even though there is scientific data to support the efficacy of ketamine treatments, it does mean a change in the way the medical community approaches mood disorders. Let’s look at history to understand this better.
Handwashing: A Radical Idea
In the late 18th and 19th centuries, there was an epidemic of puerperal fever (AKA childbed fever). Puerperal fever was a catastrophic disease. It affected women within the first 3 days after childbirth and advanced quickly, causing severe abdominal pain, fever, weakness, and even death. At the time, this was believed to be caused by blockage and stagnation of blood in the abdomen and that the best treatment involved copious bleeding of the patient.
In 1846, Dr. Ignaz Semmelweis was appointed as the director of the obstetrics clinic at Vienna General Hospital in Austria. He became increasingly concerned about the high rate of this fatal infection in women after delivery.
Surprisingly, Dr. Semmelweis noticed that the mothers who delivered with the midwives had much lower rates of infection compared to those delivered by physicians who had spent the earlier part of their day performing autopsies. He wondered if the doctors might be transferring decaying material from the corpses directly into the genitals of women?
All of this was prior to our current knowledge of the germ theory of disease. So Dr. Semmelweis proposed a policy of hand-washing between the work on cadavers and the examination of soon-to-be mothers. Immediately, the result was a 90% reduction in mortality rate and a year later the death rate was zero after instituting the hand-washing policy.
Dr. Semmelweis became a vocal proponent of handwashing but his colleagues were indifferent to the results. They thought he was crazy and rejected his idea that handwashing prior to the exams was beneficial. Ultimately, he was ostracized from the medical community and committed to a mental asylum where he died after being severely beaten by guards.
Decades later, Louis Pasteur developed the germ theory of disease and Dr. Semmelweis’ handwashing practice gained widespread acceptance which is rigorously practiced today in hospitals.
One of the great things about medical world is our ability to shift and change, but sometimes it takes more than just data and science. Sometimes our beliefs and opinions remain staunch in the face of new evidence. Some even say that medicine changes slowly - one doctor’s funeral at a time.
Treating Mental Health: Ripe For A Paradigm Shift
Today, we are in a mental health crisis. One in four adults suffer from mental illness. Very likely someone you know, if not you, will be suffering from a mental condition.
According to the World Health Organization, depression has now surpassed HIV, AIDS, malaria, diabetes, and war as the leading cause of disability. 16.2 million Americans have experienced a major depressive episode, and depression is much more common in females than males. Some studies report up to 20% of teenagers experiencing depression before they reach adulthood and statistics are showing that this rate is actually increasing.
As you know, the most serious concern with depression is that it can ultimately lead to suicide. Close to 800,000 people die by suicide every year, and according to the CDC, the national suicide rate has increased 33% between 1999 and 2017. Suicide is now the leading cause of death for Americans from the age of 10 to 34 years, and, believe it or not, there’s twice as many suicides in the U.S. as there are homicides.
Additionally, anxiety is very common today with an estimated 31% of Americans experiencing an anxiety disorder at some point in their life. Nearly two-thirds of Americans are extremely anxious or somewhat anxious about health and safety for themselves or their family. And the prevalence of anxiety is also increasing.
Furthermore, an estimated 3.6% of U.S. adults have had post-traumatic stress disorder (PTSD), and it’s not only veterans! The rate of PTSD is higher in females (about 5.2%) compared to males (1.8%), which actually stems from a lot of interpersonal violence. The overall lifetime prevalence of PTSD is at 6.8%.
So, what are some of the current medical treatments?
Some of the most commonly used drugs are selective serotonin reuptake inhibitors (antidepressants). They are effective in about a third of patients but can take weeks to months to kick in. Unfortunately, they can have a host of side effects -- loss of libido, weight gain, insomnia, anorgasmia, and suicidality. Some studies are showing that those who take SSRIs have a 33% higher mortality rate than those who don’t.
What if the serotonin system is only one part of this anxiety, depression, PTSD story? And what about other neurotransmitters that are within the brain?
Lateral Thinking: Challenging The Status Quo & Creating Change
During times of crisis what is often needed is a small segment of the population to experiment with new ideas and actions that challenge the status quo to bring about change. One psychologist, Dr. Edward De Bono, proposes the idea of lateral thinking. Lateral thinking is “a manner of solving problems using an indirect and creative approach via reasoning that is not immediately obvious,” basically thinking outside of the box. Without this ability to think laterally, we would not be able to come up with new solutions to problems.
Ketamine was created for one purpose, and pioneering doctors and scientists found a new creative way to use it to serve their patients. With rates of depression, suicidality, PTSD, and anxiety on the rise, ketamine seems to represent a new solution to a growing problem.
But like the hand-washing policy that saved lives in Vienna General Hospital, it can take time for society to change the medical community’s opinion about a new treatment.
Until that time, here at Reset Ketamine, we are committed to following the latest scientific evidence and being on the cutting edge of treatments for our patients. If you know of anyone who could benefit from ketamine or if you could potentially benefit, please share this article and reach out to us for a free consultation today.