Ketamine S-Ketamine.

They may not be fire from the gods, but they have left some burning questions that new

research is starting to answer.

Whether you prescribe those drugs or not, these new studies will help you guide your patients.

Welcome to the Carlet Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Over the past 20 years, we've figured out that ketamine treats depression, but we still have a lot of unanswered questions about the drug. How long does it work? How does it compare to other

treatments and who responds best? While we don't have full answers to any of those questions yet,

we do have new studies to share with you today that clarify the picture.

But first, the basics.

Ketamine's discovery grew out of an effort to create a safer version of fennicycladine,

also known as PCP or Angel Dust.

PCP was released as a dissociative anesthetic in 1956, but it soon fell out of favor because

of its high risk of psychiatric side effects like violence and psychosis.

Ketamine was a safer alternative and entered the U.S. market as a dissociative and aesthetic for short-term surgical procedures in 1970.

It was widely used in the Vietnam War, and many soldiers came home with ketamine use disorders.

Ketamine also has analgesic properties and is used for refractory pain.

Ketamine's antidepressant effects were discovered in 2000, and it stands out for both its rapid

action, people feel better within a day, and large effect size, 1.5. To put that in perspective,

the largest effect size for commonly used like meds is 0.9 for 5.Ans.

But we're going to present some data today that call that effect size into question.

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