Ketamine is now transforming lives as a breakthrough treatment for depression. But if you have other associations with the word ketamine, you’re not alone.
From operating rooms to battlefield medicine to party scenes – and now to mental health clinics – ketamine has had one of the most fascinating journeys in modern medicine.
But what is it exactly? Where does ketamine come from, and how did it go from anesthetic to antidepressant? Most importantly, is it safe – and can it really help treat depression?In this article, we’ll take a closer look at ketamine’s history, clarify the facts, and explain how it’s now bringing hope to people struggling with treatment-resistant depression.
Where does ketamine come from? A look at ketamine’s early history
Ketamine was first developed in the early 1960s as a safer and faster-acting alternative to other surgical anesthetics.
Its benefits were quickly realized: it worked almost immediately, didn’t suppress breathing (an issue with other anesthetics), and proved safe and effective – and in 1970, ketamine was FDA-approved for use as an anesthetic in both human and veterinary medicine.
It immediately became the anesthetic of choice, but it gained particular attention for its impact in the Vietnam War, which was at its peak during this time. Ketamine’s fast-acting effects and ease of use made it indispensable in field hospitals, as well as directly on the battlefields, and for many doctors, this was the moment ketamine earned its place in modern medicine.
Facts about ketamine: From medicine to misuse
While ketamine’s medical use was now well-established, in the 1970s and 80s it began to appear outside of medical settings.
Alongside its beneficial properties, ketamine had one particularly notable side effect: dissociation, which can cause dreamlike or out-of-body experiences. Over time, as newer anaesthetics with fewer side effects became available, this led to ketamine being gradually replaced in routine surgical procedures – although it remains widely used in trauma care and veterinary medicine to this day.
However, back in the 1970s, those same dissociative effects began attracting attention among recreational users, especially in club scenes, and ketamine gained a reputation as a party drug.
This shift raised concerns, and in response to rising misuse, ketamine was officially classified as a Schedule III controlled substance in the U.S. in 1999.
Yet even as its reputation changed in the public eye, ketamine continued to be used safely in medical settings. And increasingly, other apparent benefits of ketamine were being noticed…
Discovering ketamine as an antidepressant
In surgical recovery rooms, patients who had received ketamine often reported feeling emotionally “lighter.” This led many researchers and clinicians to wonder whether ketamine might hold broader therapeutic potential.
Eventually, in 2000, researchers at Yale University confirmed a groundbreaking discovery: at low doses, ketamine could significantly and rapidly relieve symptoms of depression – especially in people who hadn’t responded to traditional antidepressants.
This marked a major turning point in both the history of ketamine and the treatment of depression.
While traditional antidepressants typically take weeks to work, ketamine was showing a rapid and powerful effect – often within just hours – thanks to the different way it works: essentially “rebooting” the brain by repairing and renewing neural pathways.
Clinics started offering “off-label” ketamine infusions to treat depression, and it became more and more evident that it was effective. But it wasn’t official: not enough studies were done to enable FDA approval, which meant that despite its obvious benefits, it was not without risks – particularly due to its potential for misuse.
Certain researchers persisted, and over a decade later, finally succeeded in developing a more controlled version: esketamine – which uses only one of the ketamine molecules.
In 2019, the FDA approved esketamine for treatment-resistant depression, and Spravato® nasal spray became the first and only ketamine-based antidepressant officially approved for clinical use.
Ketamine vs. esketamine: What’s the difference?
When looking to understand more about ketamine therapy for depression, the distinction between ketamine and esketamine is the one that really matters.
Ketamine is the original drug that’s been used for decades as an anesthetic. While it has shown promise for treating depression, it’s not FDA-approved for that use, and when administered in high doses or without proper oversight, it carries a risk of dependency and misuse. These concerns are part of the reason ketamine remains a controlled substance today.
Esketamine, on the other hand, is a more refined version of the drug. It’s made from just one part of the ketamine molecule – the part that researchers found most effective for treating depression. This targeted approach makes it easier to dose, more predictable in its effects, and less likely to cause unwanted side effects.
Most importantly, esketamine is the only form of ketamine that’s FDA-approved for treating depression. It’s delivered in a nasal spray called Spravato®, always administered in a clinical setting under medical supervision, and only available to patients who meet specific criteria. That means no at-home use and no guessing on dosage – just safe, carefully monitored treatment with the support of your care team.
At REACH Behavioral Health Ohio, Spravato esketamine therapy is the only ketamine-based treatment we offer, because it’s FDA-approved, covered by most insurance plans, and meets the highest standards for safety, regulation, and effectiveness.
Ketamine’s medical uses: How is ketamine taken today?
Over the years, ketamine has had a wide range of medical uses – from surgery to battlefields to psychiatry.
Here’s a brief recap of ketamine’s history and journey:
- 1962 – Ketamine is first synthesized.
- 1970 – FDA approves ketamine as a surgical anesthetic.
- 1970s – Widespread, life-saving use during the Vietnam War.
- 1970s–90s – Recreational misuse rises, leading to Schedule III classification.
- 2000 – First clinical trial shows ketamine’s antidepressant effects.
- 2019 – FDA approves Spravato® (esketamine nasal spray) for treatment-resistant depression.
- Today – Ketamine therapy offers hope for people with severe, hard-to-treat depression.
Today, ketamine is still used in emergency rooms and trauma settings, and remains a trusted anesthetic in veterinary medicine. But its most exciting development has been in the world of mental health, with Spravato® – the only FDA-approved ketamine-based treatment for depression.
In terms of how ketamine is taken for depression:
Spravato® is administered as a nasal spray, but always under supervision in a licensed treatment center. Patients are monitored for at least two hours following each dose, and typically continue to take an oral antidepressant as part of their overall treatment plan.
Other ketamine therapies – such as IV infusions – are still available in some clinics but are not FDA-approved. These are considered “off-label” treatments, which means they don’t have the same safety data or insurance coverage, and we don’t offer them at REACH.
You can find out more about what to expect from Spravato treatments here, from other articles in REACH’s blog, or by contacting the REACH Ohio team.
Addressing any concerns about ketamine therapy
It’s normal to have questions about any type of medication, but even more so with a medication that has a history as varied as ketamine’s.
Many people worry about side effects, addiction, or misconceptions from ketamine’s history, but we assure you – when it comes to the Spravato (esketamine) version of ketamine therapy, there’s no need.
Here’s what you need to know:
- Ketamine is not an opioid, and it doesn’t work like painkillers or sedatives.
- Side effects of Spravato are usually mild and short-lived: things like feeling slightly disconnected, dizzy, or sleepy.
- Because Spravato is only administered in a clinical setting under professional supervision, the risk of misuse is extremely low.
- Patients are carefully screened to make sure the treatment is right for them, and closely monitored throughout.
If you’re wondering if Spravato could be the breakthrough you’ve been looking for, but still have questions or concerns, don’t be afraid to reach out. We’re here to answer all your questions and guide you through safe, supervised care with compassion and clarity.
Understanding ketamine’s history helps us use it wisely today
Ketamine’s journey from anesthetic to antidepressant has been anything but ordinary – but today, it’s offering a lifeline to people who have tried everything else without success.
At REACH Behavioral Health, we’re proud to offer safe, FDA-approved ketamine therapy that’s transforming lives. If you’re struggling with depression that hasn’t responded to other treatments, Spravato® could be the next step in your healing journey.
Contact us today, and find out about getting started with ketamine therapy at REACH Ohio.