The ketamine infusion that actor Matthew Perry received days before his death on October 28 has become a popular mental health treatment across the country.
Traditional, lower doses of anesthetics are used to treat symptoms of depression, usually administered through an IV in the clinic. While research shows promise, experts say clinics are not as well regulated.
“If there were to be a regulation, it would be taken up by the Board of Nursing and Medical Care,” said Avesta Ketamine Wellness Center, a nurse anesthetist with clinics in the Washington, D.C., area. said Radan Eshkevari, CEO. “We don’t know how it will turn out, but the world we live in now requires us to operate conscientiously and ethically now more than ever.”
Ketamine infusion clinicians said the doses are a fraction of what patients would receive in the operating room. Patients remain awake or semi-conscious during hours-long IV sessions supervised by anesthesiologists who administer drugs alongside staff such as psychiatrists, nurses and social workers who examine patients. .
The autopsy report said Perry, 54,'s ketamine infusion would not have lasted very long because the drug has a half-life of just a few hours. However, his death in his Los Angeles home swimming pool was ruled an accident due to the “acute effects of ketamine”, which were similar to those experienced during general anesthesia. Contributing factors included drowning, coronary artery disease, and the effects of buprenorphine. Perry, who had spoken publicly about his drug abuse, had reportedly been sober for 19 months, according to the autopsy report.
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Dr. Peter Grinspoon of Massachusetts General Hospital said the use of ketamine for mental health poses a risk to people with a history of substance use disorders. Harvard Medical School Article. Ketamine is also known as a street drug.
“This is not a normal drug that the average person can use,” said Dr. Fahmi Farah, a cardiologist in Fort Worth, Texas. Traditional use of ketamine in the operating room often involves constant monitoring with a ventilator to help the patient breathe, she said.
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Ketamine has shown promise for mental health. Two 2019 studies showed that esketamine, a ketamine nasal spray approved by the U.S. Food and Drug Administration to treat depression under certain circumstances, alleviates treatment-resistant depression. Ta short and longer period.
recently, F.D.A. Specifically, telemedicine companies that prescribe ketamine warned of the risks of compounded ketamine, including oral products, in the treatment of mental illness.
Health workers say clinics use doses that are a fraction of those used for anesthesia.
At Avesta in Washington, Eshkevari said doctors prescribe exact doses of esketamine. If the patient misuses it, the clinician will discontinue the prescription.
“We do an infusion protocol, but we don't prescribe it at home for people who have a history of substance use disorder,” she said, adding that doctors don't prescribe oral ketamine.
Marija Jade Payne, a somatic psychotherapist who runs Awaken Consulting Services in Minnesota, combines ketamine with psychotherapy. A mental health professional will monitor the patient during treatment.
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Infusion clinic wants people to know what they do
Sam Mandel, co-founder and CEO of Ketamine Clinic Los Angeles, said patients who had appointments after Perry's death emailed them with concerns. He said linking his death to suspicions of uncontrolled use hurts people who need help with mental health issues.
“People are afraid,” said Mandel, who founded the clinic nearly 10 years ago with his father, Dr. Steven Mandel, an anesthesiologist. “There is no connection between the therapeutic or clinical use of ketamine and what happened to Matthew (Perry).”
In Perry's case, Eshkevari said medical teams must ensure patients use ketamine responsibly. Ketamine is safe and closely monitored by doctors, but people can obtain it through online pharmacies, and there are risks for people who try to administer it themselves, she said.
