Elon Musk says ketamine can get you out of a ‘negative frame of mind’. What does the research say?
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X owner Elon Musk recently described using small amounts of ketamine “once every other week” to manage the “chemical tides” that cause his depression. He says it’s helpful to get out of a “negative frame of mind”.
This has caused a range of reactions in the media, including on X (formerly Twitter), from strong support for Musk’s choice of treatment, to allegations he has a drug problem.
But what exactly is ketamine? And what is its role in the treatment of depression?
It was first used as an anaesthetic
Ketamine is a dissociative anaesthetic used in surgery and to relieve pain.
At certain doses, people are awake but are disconnected from their bodies. This makes it useful for paramedics, for example, who can continue to talk to injured patients while the drug blocks pain but without affecting the person’s breathing or blood flow.
Ketamine is also used to sedate animals in veterinary practice.
Ketamine is a mixture of two molecules, usually referred to a S-Ketamine and R-Ketamine.
S-Ketamine, or esketamine, is stronger than R-Ketamine and was approved in 2019 in the United States under the drug name Spravato for serious and long-term depression that has not responded to at least two other types of treatments.
Ketamine is thought to change chemicals in the brain that affect mood.
While the exact way ketamine works on the brain is not known, scientists think it changes the amount of the neurotransmitter glutamate and therefore changes symptoms of depression.
How was it developed?
Ketamine was first synthesised by chemists at the Parke Davis pharmaceutical company in Michigan in the United States as an anaesthetic. It was tested on a group of prisoners at Jackson Prison in Michigan in 1964 and found to be fast acting with few side effects.
The US Food and Drug Administration approved ketamine as a general anaesthetic in 1970. It is now on the World Health Organization’s core list of essential medicines for health systems worldwide as an anaesthetic drug.
In 1994, following patient reports of improved depression symptoms after surgery where ketamine was used as the anaesthetic, researchers began studying the effects of low doses of ketamine on depression.
SB Arts Media/Shutterstock
The first clinical trial results were published in 2000. In the trial, seven people were given either intravenous ketamine or a salt solution over two days. Like the earlier case studies, ketamine was found to reduce symptoms of depression quickly, often within hours and the effects lasted up to seven days.
Over the past 20 years, researchers have studied the effects of ketamine on treatment resistant depression, bipolar disorder, post-traumatic sress disorder obsessive-compulsive disorder, eating disorders and for reducing substance use, with generally positive results.
One study in a community clinic providing ketamine intravenous therapy for depression and anxiety found the majority of patients reported improved depression symptoms eight weeks after starting regular treatment.
While this might sound like a lot of research, it’s not. A recent review of randomised controlled trials conducted up to April 2023 looking at the effects of ketamine for treating depression found only 49 studies involving a total of 3,299 patients worldwide. In comparison, in 2021 alone, there were 1,489 studies being conducted on cancer drugs.
Is ketamine prescribed in Australia?
Even though the research results on ketamine’s effectiveness are encouraging, scientists still don’t really know how it works. That’s why it’s not readily available from GPs in Australia as a standard depression treatment. Instead, ketamine is mostly used in specialised clinics and research centres.
However, the clinical use of ketamine is increasing. Spravato nasal spray was approved by the Australian Therapuetic Goods Administration (TGA) in 2021. It must be administered under the direct supervision of a health-care professional, usually a psychiatrist.
Spravato dosage and frequency varies for each person. People usually start with three to six doses over several weeks to see how it works, moving to fortnightly treatment as a maintenance dose. The nasal spray costs between A$600 and $900 per dose, which will significantly limit many people’s access to the drug.
Ketamine can be prescribed “off-label” by GPs in Australia who can prescribe schedule 8 drugs. This means it is up to the GP to assess the person and their medication needs. But experts in the drug recommend caution because of the lack of research into negative side-effects and longer-term effects.
What about its illicit use?
Concern about use and misuse of ketamine is heightened by highly publicised deaths connected to the drug.
Ketamine has been used as a recreational drug since the 1970s. People report it makes them feel euphoric, trance-like, floating and dreamy. However, the amounts used recreationally are typically higher than those used to treat depression.
Information about deaths due to ketamine is limited. Those that are reported are due to accidents or ketamine combined with other drugs. No deaths have been reported in treatment settings.
Reducing stigma
Depression is the third leading cause of disability worldwide and effective treatments are needed.
Seeking medical advice about treatment for depression is wiser than taking Musk’s advice on which drugs to use.
However, Musk’s public discussion of his mental health challenges and experiences of treatment has the potential to reduce stigma around depression and help-seeking for mental health conditions.
Clarification: this article previously referred to a systematic review looking at oral ketamine to treat depression. The article has been updated to instead cite a review that encompasses other routes of administration as well, such as intravenous and intranasal ketamine.
Julaine Allan, Associate Professor, Mental Health and Addiction, Rural Health Research Institute, Charles Sturt University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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6 Lifestyle Factors To Measurably Reduce Biological Age
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Julie Gibson Clark competes on a global leaderboard of people actively fighting aging (including billionaire Bryan Johnson, who is famously very focused on such). She’s currently ahead of him on that leaderboard, so what’s she doing?
Top tips
We’ll not keep the six factors a mystery; they are:
- Exercise: her weekly exercise includes VO2 Max training, strength training, balance work, and low-intensity cardio. She exercises outdoors on Saturdays and takes rest days on Fridays and Sundays.
- Diet: she follows a 16-hour intermittent fasting schedule (eating between 09:00–17:00), consumes a clean omnivore diet with an emphasis on vegetables and adequate protein, and avoids junk food.
- Brain: she meditates for 20 minutes daily, prioritizes mental health, and ensures sufficient quality sleep, helped by morning sunlight exposure and time in nature.
- Hormesis: she engages in 20-minute sauna sessions followed by cold showers four times per week to support recovery and longevity.
- Supplements: she takes longevity supplements and bioidentical hormones to optimize her health and aging process.
- Testing: she regularly monitors her biological age and health markers through various tests, including DEXA scans, VO2 Max tests, lipid panels, and epigenetic aging clocks, allowing her to adjust her routine accordingly.
For more on all of these, enjoy:
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Want to learn more?
You might also like to read:
Age & Aging: What Can (And Can’t) We Do About It?
Take care!
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Tuna vs Catfish – Which is Healthier?
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Our Verdict
When comparing tuna to catfish, we picked the tuna.
Why?
Today in “that which is more expensive and/or harder to get is not necessarily healthier”…
Looking at their macros, tuna has more protein and less fat (and overall, less saturated fat, and also less cholesterol).
In the category of vitamins, both are good but tuna distinguishes itself: tuna has more of vitamins A, B1, B2, B3, B6, and D, while catfish has more of vitamins B5, B9, B12, E, and K. They are both approximately equal in choline, and as an extra note in tuna’s favor (already winning 6:5), tuna is a very good source of vitamin D, while catfish barely contains any. All in all: a moderate, but convincing, win for tuna.
When it comes to minerals, things are clearer still: tuna has more copper, iron, magnesium, phosphorus, potassium, and selenium, while catfish has more calcium, manganese, and zinc. Oh, and catfish is also higher in one other mineral: sodium, which most people in industrialized countries need less of, on average. So, a 6:3 win for tuna, before we even take into account the sodium content (which makes the win for tuna even stronger).
In short: tuna wins the day in every category!
Want to learn more?
You might like to read:
Farmed Fish vs Wild Caught (It Makes Quite A Difference)
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It Didn’t Start with You – by Mark Wolynn
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There is a trend in psychology to “blame the parents” for “childhood trauma” that can result in problems later in life. Sometimes fairly, sometimes not. This book’s mostly not about that.
It does touch on our own childhood trauma, if applicable. But mostly, it’s about epigenetic trauma inheritance. In other words, not just trauma that’s passed on in terms of “the cycle of abuse”, but trauma that’s passed on in terms of “this generation experienced trauma x, developed trauma response y, encoded it epigenetically, and passed it on to their offspring”.
So, how does one heal from a trauma one never directly experienced, and just inherited the response to it? That’s what most of this book is about, after establishing how epigenetic trauma inheritance works.
The author, a therapist, provides practical advice for how to do the things that can be done to rewrite the epigenetic code we inherited. Better late than never!
Bottom line: it is well-established that trauma is inheritable. But unlike one’s eye color or the ability to smell asparagus metabolites in urine, we can rewrite epigenetic things, to a degree. This book explains how.
Click here to check out It Didn’t Start With You, and put things to rest!
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What Nobody Teaches You About Strengthening Your Knees
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Strengthening unhappy knees can seem difficult, because many obvious exercises like squats may hurt, and can feel like they are doing harm (and if your knees are bad enough, maybe they are; it depends on many factors). Here’s a way to improve things:
The muscle nobody talks about
Well, not nobody. But, it’s a muscle that’s rarely talked about; namely, the tibialis anterior.
It plays a key role in decelerating knee motion—in other words, the movement that hurts if you have bad knees. It’s essential for absorbing shock during activities like walking, climbing stairs, and stepping off curbs
So, of course, strengthening this muscle supports knee health.
The exercise this video recommends for strengthening it involves leaning against a wall with feet about a foot away (closer feet make it easier, further makes it harder). Note, this is a lean, not a “Roman chair”.
The exercise involves squeezing the quadriceps, lifting toes toward the nose, and engaging the tibialis anterior muscle. If you’re wondering what to do with your hands, they can be held out with palms open to work on posture, or hanging by the sides. Do this for about 1½–2 minutes.
For more on all this, plus a visual demonstration, enjoy:
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Want to learn more?
You might also like to read:
When Bad Joints Stop You From Exercising (5 Things To Change)
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Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
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What’s The Deal With MSG?
There are a lot of popular beliefs about MSG. Is there a grain of truth, or should we take them with a grain of salt? We’ll leap straight into myth-busting:
MSG is high in salt
True (technically) False (practically)
- MSG is a salt (a monosodium salt of L-glutamic acid), but to call it “full of salt” in practical terms is like calling coffee “full of fruit”. (Coffee beans are botanically fruit)
- It does contain sodium, though which is what the S stands for!
- We talked previously about how MSG’s sodium content is much lower than that of (table) salt. Specifically, it’s about one third of that of sodium chloride (e.g. table salt).
MSG triggers gluten sensitivity
False!
Or at least, because this kind of absolute negative is hard to prove in science, what we can say categorically is: it does not contain gluten. We understand that the similar name can cause that confusion. However:
- Gluten is a protein, found in wheat (and thus wheat-based foods).
- Glutamate is an amino acid, found in protein-rich foods.
- If you’re thinking “but proteins are made from amino acids”, yes, they are, but the foundational amino acid of gluten is glutamine, not glutamate. Different bricks → different house!
The body can’t process MSG correctly
False!
The body has glutamate receptors throughout the gut and nervous system.
The body metabolizes glutamate from MSG just the same as from any other food that contains it naturally.
Read: Update on food safety of monosodium l-glutamate (MSG) ← evidence-based safety review
MSG causes “Chinese Restaurant Syndrome”
False!
Racism causes that. It finds its origins in what was originally intended as a satirical joke, that the papers picked up and ran with, giving it that name in the 1960s. As to why it grew and persisted, that has more to do with US politics (the US has been often at odds with China for a long time) and xenophobia (people distrust immigrants, such as those who opened restaurants), including nationalistic rhetoric associating immigrants with diseases.
Read: Xenophobia in America in the Age of Coronavirus and Beyond ← academic paper that gives quite a compact yet comprehensive overview
Research science, meanwhile, has not found any such correlation, in more than 40 years of looking.
PS: we realize this item in the list is very US-centric. Apologies to our non-US subscribers. We know that this belief isn’t so much of a thing outside the US—though it certainly can crop up elsewhere sometimes, too.
Are there any health risks associated with MSG, then?
Well, as noted, it does contain sodium, albeit much less than table salt. So… do go easy on it, all the same.
Aside from that, the LD50 (a way of measuring toxicity) of MSG is 15.8g/kg, so if for example you weigh 150lb (68 kg), don’t eat 2.2lb (a kilogram) of MSG.
There have been some studies on rats (or in one case, fruit flies) that found high doses of MSG could cause heart problems and/or promote obesity. However:
- this has not been observed to be the case in humans
- those doses were really high, ranging from 1g/kg to 8g/kg. So that’d be the equivalent of our 150lb person eating it by the cupful
- it was injected (as a solution) into the rats, not ingested by them
- so don’t let someone inject you with a cup of MSG!
Read: A review of the alleged health hazards of monosodium glutamate
Bottom line on MSG and health:
Enjoy in moderation, but enjoy if you wish! MSG is just the salt form of the amino acid glutamate, which is found naturally in many foods, including shrimp, seaweed, and tomatoes.
Scientists have spent more than 40 years trying to find health risks for MSG, and will probably keep trying (which is as science should be), but for now… Everything has either come up negative, or has been the result of injecting laboratory animals with megadoses.
If you’d like to try it in your cooking as a low-sodium way to bring out the flavor of your dishes, you can order it online. Cheapest in bulk, but try it and see if you like it first!
(I’ll be real with you… I have 5 kg in the pantry myself and use about half a teaspoon a day, cooking for two)
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Caffeine: Cognitive Enhancer Or Brain-Wrecker?
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The Two Sides Of Caffeine
We asked you for your health-related opinions on caffeine itself, not necessarily the coffee, tea, energy drinks, etc that might contain it.
We have, by the way previously written about the health effects of coffee and tea specifically:
As for our question about caffeine itself, though, we got the above-depicted, below-described, set of results:
- About 59% said “caffeine is a safe stimulant and cognitive enhancer”
- About 31% said “caffeine is a moderately safe recreational drug”
- About 8% said “caffeine’s addictive properties make it de facto bad”
- One (1) person said “caffeine will leave you a trembling exhausted wreck”
But what does the science say?
Caffeine is addictive: True or False?
True, though one will find occasional academics quibbling the definition. Most of the studies into the mechanisms of caffeine addiction have been conducted on rats, but human studies exist too and caffeine is generally considered addictive for humans, for example:
See also:
Notwithstanding its addictive status, caffeine is otherwise safe: True or False?
True-ish, for most people. Some people with heart conditions or a hypersensitivity to caffeine may find it is not safe for them at all, and for the rest of us, the dose makes the poison. For example:
❝Can too much caffeine kill you? Although quite rare, caffeine can be fatal in cases of overdose; such circumstances are generally not applicable to healthy individuals who typically consume caffeine via beverages such as tea or coffee.❞
this paper, by the way, also includes a good example of academics quibbling the definition of addiction!
Caffeine is a cognitive enhancer: True or False?
True, but only in the case of occasional use. If you are using it all the time, your physiology will normalize it and you will require caffeine in order to function at your normal level. To attain higher than that, once addicted to caffeine, would now require something else.
Read more: Caffeine: benefits and drawbacks for technical performance
Caffeine will leave you a trembling exhausted wreck: True or False?
True or False depending on usage:
- The famously moderate 3–5 cups per day will not, for most people, cause any such problems.
- Using/abusing it to make up for lost sleep (or some other source of fatigue, such as physical exhaustion from exertion), however, is much more likely to run into problems.
In the latter case, caffeine really is the “payday loan” of energy! It’ll give you an adrenal boost now (in return, you must suffer the adrenal dumping later, along with lost energy expended in the adrenaline surge), and also, the tiredness that you thought was gone, was just caffeine’s adenosine-blocking activities temporarily preventing you from being able to perceive the tiredness. So you’ll have to pay that back later, with interest, because of the extra time/exertion too.
Want to make caffeine a little more gentle on your system?
Taking l-theanine alongside caffeine can ameliorate some of caffeine’s less wonderful effects—and as a bonus, l-theanine has some nifty benefits of its own, too:
Enjoy!
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